Rheopheresis for Digital Ulcers and Raynaud's Phenomenon in Systemic Sclerosis Refractory to Conventional Treatments
Identifieur interne : 000462 ( Main/Exploration ); précédent : 000461; suivant : 000463Rheopheresis for Digital Ulcers and Raynaud's Phenomenon in Systemic Sclerosis Refractory to Conventional Treatments
Auteurs : Peter Korsten ; Gerhard A. Müller ; Jan-Gerd Rademacher ; Michael Zeisberg ; Björn TampeSource :
- Frontiers in Medicine [ 2296-858X ] ; 2019.
Abstract
Raynaud's phenomenon (RP) is almost universally present in patients with Systemic Sclerosis (SSc). RP represents a generalized vasculopathy and potentially lead to digital ulcers (DU), which may be complicated by superinfection, tissue necrosis, and limb loss. We report the analysis of an extracorporeal procedure in a 36-year-old female patient with diffuse SSc with refractory RP and DU despite treatment with diltiazem, candesartan, sildenafil, and intravenous iloprost. We performed rheopheresis (RheoP), a variant of double-filtration plasmapheresis, as a potential new treatment option for refractory patients despite optimal medical therapy. We performed two RheoP per week every 4 weeks for a total of 3 months. Clinical improvement in DU healing occurred with no adverse events directly related to the treatment. While there was no reduction in the number of Raynaud attacks with RheoP, a significant reduction of the duration of attacks from a median of 15 (5–45, 95% CI 10–15) to 7 (3–30, 95% CI 6–10) minutes with an improvement of the Raynaud Condition Score (RCS) improved from 4 to 2. In conclusion, RheoP is a feasible and potentially beneficial treatment modality in patients with refractory RP and DU. We propose that RheoP should be investigated in a larger number of patients in a clinical trial setting.
Url:
DOI: 10.3389/fmed.2019.00208
PubMed: 31620442
PubMed Central: 6759692
Affiliations:
Links toward previous steps (curation, corpus...)
- to stream Pmc, to step Corpus: 000295
- to stream Pmc, to step Curation: 000295
- to stream Pmc, to step Checkpoint: 000418
- to stream Ncbi, to step Merge: 000B12
- to stream Ncbi, to step Curation: 000B12
- to stream Ncbi, to step Checkpoint: 000B12
- to stream Main, to step Merge: 000462
- to stream Main, to step Curation: 000462
Le document en format XML
<record><TEI><teiHeader><fileDesc><titleStmt><title xml:lang="en">Rheopheresis for Digital Ulcers and Raynaud's Phenomenon in Systemic Sclerosis Refractory to Conventional Treatments</title><author><name sortKey="Korsten, Peter" sort="Korsten, Peter" uniqKey="Korsten P" first="Peter" last="Korsten">Peter Korsten</name></author><author><name sortKey="Muller, Gerhard A" sort="Muller, Gerhard A" uniqKey="Muller G" first="Gerhard A." last="Müller">Gerhard A. Müller</name></author><author><name sortKey="Rademacher, Jan Gerd" sort="Rademacher, Jan Gerd" uniqKey="Rademacher J" first="Jan-Gerd" last="Rademacher">Jan-Gerd Rademacher</name></author><author><name sortKey="Zeisberg, Michael" sort="Zeisberg, Michael" uniqKey="Zeisberg M" first="Michael" last="Zeisberg">Michael Zeisberg</name></author><author><name sortKey="Tampe, Bjorn" sort="Tampe, Bjorn" uniqKey="Tampe B" first="Björn" last="Tampe">Björn Tampe</name></author></titleStmt><publicationStmt><idno type="wicri:source">PMC</idno><idno type="pmid">31620442</idno><idno type="pmc">6759692</idno><idno type="url">http://www.ncbi.nlm.nih.gov/pmc/articles/PMC6759692</idno><idno type="RBID">PMC:6759692</idno><idno type="doi">10.3389/fmed.2019.00208</idno><date when="2019">2019</date><idno type="wicri:Area/Pmc/Corpus">000295</idno><idno type="wicri:explorRef" wicri:stream="Pmc" wicri:step="Corpus" wicri:corpus="PMC">000295</idno><idno type="wicri:Area/Pmc/Curation">000295</idno><idno type="wicri:explorRef" wicri:stream="Pmc" wicri:step="Curation">000295</idno><idno type="wicri:Area/Pmc/Checkpoint">000418</idno><idno type="wicri:explorRef" wicri:stream="Pmc" wicri:step="Checkpoint">000418</idno><idno type="wicri:Area/Ncbi/Merge">000B12</idno><idno type="wicri:Area/Ncbi/Curation">000B12</idno><idno type="wicri:Area/Ncbi/Checkpoint">000B12</idno><idno type="wicri:Area/Main/Merge">000462</idno><idno type="wicri:Area/Main/Curation">000462</idno><idno type="wicri:Area/Main/Exploration">000462</idno></publicationStmt><sourceDesc><biblStruct><analytic><title xml:lang="en" level="a" type="main">Rheopheresis for Digital Ulcers and Raynaud's Phenomenon in Systemic Sclerosis Refractory to Conventional Treatments</title><author><name sortKey="Korsten, Peter" sort="Korsten, Peter" uniqKey="Korsten P" first="Peter" last="Korsten">Peter Korsten</name></author><author><name sortKey="Muller, Gerhard A" sort="Muller, Gerhard A" uniqKey="Muller G" first="Gerhard A." last="Müller">Gerhard A. Müller</name></author><author><name sortKey="Rademacher, Jan Gerd" sort="Rademacher, Jan Gerd" uniqKey="Rademacher J" first="Jan-Gerd" last="Rademacher">Jan-Gerd Rademacher</name></author><author><name sortKey="Zeisberg, Michael" sort="Zeisberg, Michael" uniqKey="Zeisberg M" first="Michael" last="Zeisberg">Michael Zeisberg</name></author><author><name sortKey="Tampe, Bjorn" sort="Tampe, Bjorn" uniqKey="Tampe B" first="Björn" last="Tampe">Björn Tampe</name></author></analytic><series><title level="j">Frontiers in Medicine</title><idno type="eISSN">2296-858X</idno><imprint><date when="2019">2019</date></imprint></series></biblStruct></sourceDesc></fileDesc><profileDesc><textClass></textClass></profileDesc></teiHeader><front><div type="abstract" xml:lang="en"><p>Raynaud's phenomenon (RP) is almost universally present in patients with Systemic Sclerosis (SSc). RP represents a generalized vasculopathy and potentially lead to digital ulcers (DU), which may be complicated by superinfection, tissue necrosis, and limb loss. We report the analysis of an extracorporeal procedure in a 36-year-old female patient with diffuse SSc with refractory RP and DU despite treatment with diltiazem, candesartan, sildenafil, and intravenous iloprost. We performed rheopheresis (RheoP), a variant of double-filtration plasmapheresis, as a potential new treatment option for refractory patients despite optimal medical therapy. We performed two RheoP per week every 4 weeks for a total of 3 months. Clinical improvement in DU healing occurred with no adverse events directly related to the treatment. While there was no reduction in the number of Raynaud attacks with RheoP, a significant reduction of the duration of attacks from a median of 15 (5–45, 95% CI 10–15) to 7 (3–30, 95% CI 6–10) minutes with an improvement of the Raynaud Condition Score (RCS) improved from 4 to 2. In conclusion, RheoP is a feasible and potentially beneficial treatment modality in patients with refractory RP and DU. We propose that RheoP should be investigated in a larger number of patients in a clinical trial setting.</p></div></front><back><div1 type="bibliography"><listBibl><biblStruct><analytic><author><name sortKey="Gabrielli, A" uniqKey="Gabrielli A">A Gabrielli</name></author><author><name sortKey="Avvedimento, Ev" uniqKey="Avvedimento E">EV Avvedimento</name></author><author><name sortKey="Krieg, T" uniqKey="Krieg T">T Krieg</name></author></analytic></biblStruct><biblStruct><analytic><author><name sortKey="Steen, V" uniqKey="Steen V">V Steen</name></author><author><name sortKey="Denton, Cp" uniqKey="Denton C">CP Denton</name></author><author><name sortKey="Pope, Je" uniqKey="Pope J">JE Pope</name></author><author><name sortKey="Matucci Cerinic, M" uniqKey="Matucci Cerinic M">M Matucci-Cerinic</name></author></analytic></biblStruct><biblStruct><analytic><author><name sortKey="Kowal Bielecka, O" uniqKey="Kowal Bielecka O">O Kowal-Bielecka</name></author><author><name sortKey="Fransen, J" uniqKey="Fransen J">J Fransen</name></author><author><name sortKey="Avouac, J" uniqKey="Avouac J">J Avouac</name></author><author><name sortKey="Becker, M" uniqKey="Becker M">M Becker</name></author><author><name sortKey="Kulak, A" uniqKey="Kulak A">A Kulak</name></author><author><name sortKey="Allanore, Y" uniqKey="Allanore Y">Y Allanore</name></author></analytic></biblStruct><biblStruct><analytic><author><name sortKey="Korn, Jh" uniqKey="Korn J">JH Korn</name></author><author><name sortKey="Mayes, M" uniqKey="Mayes M">M Mayes</name></author><author><name sortKey="Matucci Cerinic, M" uniqKey="Matucci Cerinic M">M Matucci Cerinic</name></author><author><name sortKey="Rainisio, M" uniqKey="Rainisio M">M Rainisio</name></author><author><name sortKey="Pope, J" uniqKey="Pope J">J Pope</name></author><author><name sortKey="Hachulla, E" uniqKey="Hachulla E">E Hachulla</name></author></analytic></biblStruct><biblStruct><analytic><author><name sortKey="Khanna, D" uniqKey="Khanna D">D Khanna</name></author><author><name sortKey="Denton, Cp" uniqKey="Denton C">CP Denton</name></author><author><name sortKey="Merkel, Pa" uniqKey="Merkel P">PA Merkel</name></author><author><name sortKey="Krieg, T" uniqKey="Krieg T">T Krieg</name></author><author><name sortKey="Le Brun, F O" uniqKey="Le Brun F">F-O Le Brun</name></author><author><name sortKey="Marr, A" uniqKey="Marr A">A Marr</name></author></analytic></biblStruct><biblStruct><analytic><author><name sortKey="Vaya, A" uniqKey="Vaya A">A Vayá</name></author><author><name sortKey="Todoli, J" uniqKey="Todoli J">J Todolí</name></author><author><name sortKey="Calvo, J" uniqKey="Calvo J">J Calvo</name></author><author><name sortKey="Romagnoli, M" uniqKey="Romagnoli M">M Romagnoli</name></author><author><name sortKey="Ricart, Jm" uniqKey="Ricart J">JM Ricart</name></author></analytic></biblStruct><biblStruct><analytic><author><name sortKey="Korsten, P" uniqKey="Korsten P">P Korsten</name></author><author><name sortKey="Niewold, Tb" uniqKey="Niewold T">TB Niewold</name></author><author><name sortKey="Zeisberg, M" uniqKey="Zeisberg M">M Zeisberg</name></author><author><name sortKey="Utset, To" uniqKey="Utset T">TO Utset</name></author><author><name sortKey="Cho, D" uniqKey="Cho D">D Cho</name></author><author><name sortKey="Zachary, Ls" uniqKey="Zachary L">LS Zachary</name></author></analytic></biblStruct><biblStruct><analytic><author><name sortKey="Harris, Es" uniqKey="Harris E">ES Harris</name></author><author><name sortKey="Meiselman, Hj" uniqKey="Meiselman H">HJ Meiselman</name></author><author><name sortKey="Moriarty, Pm" uniqKey="Moriarty P">PM Moriarty</name></author><author><name sortKey="Metzger, A" uniqKey="Metzger A">A Metzger</name></author><author><name sortKey="Malkovsky, M" uniqKey="Malkovsky M">M Malkovsky</name></author></analytic></biblStruct><biblStruct><analytic><author><name sortKey="Koss, Mj" uniqKey="Koss M">MJ Koss</name></author><author><name sortKey="Kurz, P" uniqKey="Kurz P">P Kurz</name></author><author><name sortKey="Tsobanelis, T" uniqKey="Tsobanelis T">T Tsobanelis</name></author><author><name sortKey="Lehmacher, W" uniqKey="Lehmacher W">W Lehmacher</name></author><author><name sortKey="Fassbender, C" uniqKey="Fassbender C">C Fassbender</name></author><author><name sortKey="Klingel, R" uniqKey="Klingel R">R Klingel</name></author></analytic></biblStruct><biblStruct><analytic><author><name sortKey="Klingel, R" uniqKey="Klingel R">R Klingel</name></author><author><name sortKey="Erdtracht, B" uniqKey="Erdtracht B">B Erdtracht</name></author><author><name sortKey="Gauss, V" uniqKey="Gauss V">V Gauss</name></author><author><name sortKey="Piazolo, A" uniqKey="Piazolo A">A Piazolo</name></author><author><name sortKey="Mausfeld Lafdhiya, P" uniqKey="Mausfeld Lafdhiya P">P Mausfeld-Lafdhiya</name></author><author><name sortKey="Diehm, C" uniqKey="Diehm C">C Diehm</name></author></analytic></biblStruct><biblStruct><analytic><author><name sortKey="Klingel, R" uniqKey="Klingel R">R Klingel</name></author><author><name sortKey="Mumme, C" uniqKey="Mumme C">C Mumme</name></author><author><name sortKey="Fassbender, T" uniqKey="Fassbender T">T Fassbender</name></author><author><name sortKey="Himmelsbach, F" uniqKey="Himmelsbach F">F Himmelsbach</name></author><author><name sortKey="Altes, U" uniqKey="Altes U">U Altes</name></author><author><name sortKey="Lotz, J" uniqKey="Lotz J">J Lotz</name></author><author><name sortKey="Pohlmann, T" uniqKey="Pohlmann T">T Pohlmann</name></author></analytic></biblStruct><biblStruct><analytic><author><name sortKey="Lutze, S" uniqKey="Lutze S">S Lutze</name></author><author><name sortKey="Daeschlein, G" uniqKey="Daeschlein G">G Daeschlein</name></author><author><name sortKey="Konschake, W" uniqKey="Konschake W">W Konschake</name></author><author><name sortKey="Junger, M" uniqKey="Junger M">M Jünger</name></author></analytic></biblStruct><biblStruct><analytic><author><name sortKey="Suliman, Ya" uniqKey="Suliman Y">YA Suliman</name></author><author><name sortKey="Bruni, C" uniqKey="Bruni C">C Bruni</name></author><author><name sortKey="Johnson, Sr" uniqKey="Johnson S">SR Johnson</name></author><author><name sortKey="Praino, E" uniqKey="Praino E">E Praino</name></author><author><name sortKey="Alemam, M" uniqKey="Alemam M">M Alemam</name></author><author><name sortKey="Borazan, N" uniqKey="Borazan N">N Borazan</name></author></analytic></biblStruct><biblStruct><analytic><author><name sortKey="Coghlan, Jg" uniqKey="Coghlan J">JG Coghlan</name></author><author><name sortKey="Denton, Cp" uniqKey="Denton C">CP Denton</name></author><author><name sortKey="Grunig, E" uniqKey="Grunig E">E Grünig</name></author><author><name sortKey="Bonderman, D" uniqKey="Bonderman D">D Bonderman</name></author><author><name sortKey="Distler, O" uniqKey="Distler O">O Distler</name></author><author><name sortKey="Khanna, D" uniqKey="Khanna D">D Khanna</name></author></analytic></biblStruct><biblStruct><analytic><author><name sortKey="Harris, Es" uniqKey="Harris E">ES Harris</name></author><author><name sortKey="Meiselman, Hj" uniqKey="Meiselman H">HJ Meiselman</name></author><author><name sortKey="Moriarty, Pm" uniqKey="Moriarty P">PM Moriarty</name></author><author><name sortKey="Weiss, J" uniqKey="Weiss J">J Weiss</name></author></analytic></biblStruct><biblStruct><analytic><author><name sortKey="Herrick, Al" uniqKey="Herrick A">AL Herrick</name></author></analytic></biblStruct><biblStruct><analytic><author><name sortKey="Nwose, Eu" uniqKey="Nwose E">EU Nwose</name></author><author><name sortKey="Richards, Rs" uniqKey="Richards R">RS Richards</name></author></analytic></biblStruct><biblStruct><analytic><author><name sortKey="Cabral Marques, O" uniqKey="Cabral Marques O">O Cabral-Marques</name></author><author><name sortKey="Riemekasten, G" uniqKey="Riemekasten G">G Riemekasten</name></author></analytic></biblStruct><biblStruct><analytic><author><name sortKey="Riemekasten, G" uniqKey="Riemekasten G">G Riemekasten</name></author><author><name sortKey="Cabral Marques, O" uniqKey="Cabral Marques O">O Cabral-Marques</name></author></analytic></biblStruct></listBibl></div1></back></TEI><affiliations><list></list><tree><noCountry><name sortKey="Korsten, Peter" sort="Korsten, Peter" uniqKey="Korsten P" first="Peter" last="Korsten">Peter Korsten</name><name sortKey="Muller, Gerhard A" sort="Muller, Gerhard A" uniqKey="Muller G" first="Gerhard A." last="Müller">Gerhard A. Müller</name><name sortKey="Rademacher, Jan Gerd" sort="Rademacher, Jan Gerd" uniqKey="Rademacher J" first="Jan-Gerd" last="Rademacher">Jan-Gerd Rademacher</name><name sortKey="Tampe, Bjorn" sort="Tampe, Bjorn" uniqKey="Tampe B" first="Björn" last="Tampe">Björn Tampe</name><name sortKey="Zeisberg, Michael" sort="Zeisberg, Michael" uniqKey="Zeisberg M" first="Michael" last="Zeisberg">Michael Zeisberg</name></noCountry></tree></affiliations></record>Pour manipuler ce document sous Unix (Dilib)
EXPLOR_STEP=$WICRI_ROOT/Sante/explor/ChloroquineV1/Data/Main/Exploration
HfdSelect -h $EXPLOR_STEP/biblio.hfd -nk 000462 | SxmlIndent | more
Ou
HfdSelect -h $EXPLOR_AREA/Data/Main/Exploration/biblio.hfd -nk 000462 | SxmlIndent | more
Pour mettre un lien sur cette page dans le réseau Wicri
{{Explor lien
|wiki= Sante
|area= ChloroquineV1
|flux= Main
|étape= Exploration
|type= RBID
|clé= PMC:6759692
|texte= Rheopheresis for Digital Ulcers and Raynaud's Phenomenon in Systemic Sclerosis Refractory to Conventional Treatments
}}
Pour générer des pages wiki
HfdIndexSelect -h $EXPLOR_AREA/Data/Main/Exploration/RBID.i -Sk "pubmed:31620442" \
| HfdSelect -Kh $EXPLOR_AREA/Data/Main/Exploration/biblio.hfd \
| NlmPubMed2Wicri -a ChloroquineV1
| This area was generated with Dilib version V0.6.33. |  |