[How to evaluate prospectively cutaneous sclerosis in systemic scleroderma?].
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Experience gained with the use of captopril has been summarized in 5 patients with sclerodermic renal crisis (true sclerodermic kidney) as well as the results of the double blind clinical trial of captopril in 16 patients with Raynaud's syndrome. Captopril given for a long time in the dose 75-150 mg to the patients with true sclerodermic kidney turned out effective which showed up by a decline and stabilization of arterial pressure, decrease of the intensity of azotemia and headaches, and stabilization of renal function. No convincing data have been obtained, that may confirm a beneficial effect of captopril on Raynaud's syndrome. The drug was applied in a dose of 37.5 mg for 2 weeks.
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Clinical effect of plasma- and lymphoplasmapheresis in patients with various patterns of sclerodermia systematica was studied in 12 females with subacute and chronic course of the disease. The failure of the drug therapy preceded, the complications associated with corticosteroid treatment performed were the indications to the aforementioned procedures. The treatment course comprised 3-5 procedures with an interval of 2-3 days. During 1 plasmapheresis session 1000-1200 ml of the plasma were removed and 1100-1250 ml of the plasma and 4.5.10(9)-7.0.10(9) lymphocytes were removed by a session of lymphoplasmapheresis. The results obtained evidenced a positive influence of plasma- and lymphoplasmapheresis on the course of sclerodermia systematica, contributed to a decrease in the clinical manifestation of the disease and laboratory data indicating the activity of inflammation, led to a more rapid regression of the main symptoms of the disease than it was recorded during the routine treatment, promoted a longer remission and a significant reduction of the hormone dosage.
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