tetracycline and Scleroderma--Systemic

While the biology of the pathogenesis of scleroderma is continually being better understood, there still is no single agent or therapeutic combination that has a clear impact on the disease process. Traditional medications (colchicine, potassium aminobenzoate (potaba), D-penicillamine) are disappointing in clinical practice despite anecdotal evidence of benefit. Furthermore, the most popular traditional drug, D-penicillamine, failed to clearly show benefit when tested in a well-designed clinical trial comparing conventional high dose with a very low dose (125 mg po. every other day [corrected]) [1]. Currently, most success in managing scleroderma and improving quality of life is secondary to organ-specific therapy, such as management of a renal crisis with an ACE inhibitor, treatment of Raynaud's phenomenon with calcium channel blockers, or control of serious gastrointestinal reflux disease with a proton pump inhibitor. In this review we will focus on novel therapies that are currently being tested in the treatment of scleroderma and have the potential of modifying the disease process and overall clinical outcome. We have attempted to review the rationale for each agent, recognising that its true biological effect will only be determined in clinical trials.

Topics: Autoimmune Diseases; Bone Marrow Transplantation; Cysteine; Humans; Interferon-gamma; Nitric Oxide; Piperidines; Prostaglandins; Quinazolines; Quinazolinones; Relaxin; Scleroderma, Systemic; Tetracycline; Transforming Growth Factor beta; Tumor Necrosis Factor-alpha

A 58-year-old white female who had regional enteritis for many years insidiously developed scleroderma. A review of the literature failed to reveal any previous reports of this combination of diseases. The possible etiologies of both diseases are discussed along with their overlapping clinical manifestations.

Topics: Colostomy; Contracture; Crohn Disease; Female; Hand Deformities, Acquired; Humans; Middle Aged; Postoperative Complications; Prednisone; Radiography; Recurrence; Scleroderma, Systemic; Tetracycline; Vitamins

Topics: Aged; Female; Humans; Infarction; Intestinal Obstruction; Intestine, Small; Jejunum; Kidney; Malabsorption Syndromes; Scleroderma, Systemic; Sclerosis; Tetracycline

Topics: Acrodermatitis; Adult; Diagnosis, Differential; Erysipelas; Female; Frostbite; Humans; Male; Middle Aged; Penicillins; Prognosis; Raynaud Disease; Rheumatic Nodule; Scleroderma, Systemic; Tetracycline; Thrombophlebitis

Topics: Adult; Celiac Disease; Chloramphenicol; Female; Humans; Intestinal Diseases; Intestinal Obstruction; Intestine, Small; Jejunum; Malabsorption Syndromes; Middle Aged; Pneumatosis Cystoides Intestinalis; Pneumoperitoneum; Radiography; Scleroderma, Systemic; Tetracycline; Vitamin B 12; Xylose