Treatment of Systemic Sclerosis-Associated Calcinosis: A Case Report of Rituximab-Induced Regression of CREST-Related Calcinosis and Review of the Literature

被引：51

作者：

Daoussis, Dimitrios ^{[1
]}

Antonopoulos, Ioannis ^{[1
]}

Liossis, Stamatis-Nick C. ^{[1
]}

Yiannopoulos, Georgios ^{[1
]}

Andonopoulos, Andrew P. ^{[1
]}

机构：

[1] Univ Patras, Sch Med, Patras Univ Hosp, Dept Internal Med,Div Rheumatol, Patras 26504, Greece

来源：

SEMINARS IN ARTHRITIS AND RHEUMATISM | 2012年 / 41卷 / 06期

关键词：

Rituximab; B cells; systemic sclerosis; scleroderma; limited; CREST; calcinosis; calcification; treatment; warfarin; diltiazem; IVIG; minocycline; biphosphonates; laser; lithotripsy; MATRIX GLA PROTEIN; B-CELL DEPLETION; TIGHT-SKIN MOUSE; INTERSTITIAL LUNG-DISEASE; CARBON-DIOXIDE LASER; LOW-DOSE WARFARIN; JUVENILE DERMATOMYOSITIS; CUTANEOUS CALCINOSIS; INTRAVENOUS IMMUNOGLOBULIN; ECTOPIC CALCIFICATION;

D O I：

10.1016/j.semarthrit.2011.11.007

中图分类号：

R5 [内科学];

学科分类号：

1002 ; 100201 ;

摘要：

Objectives: Calcinosis is frequently encountered in patients with systemic sclerosis (SSc) and may be associated with significant morbidity. No treatment has shown so far an unequivocal beneficial effect. Methods: We performed an extensive internet search (MEDLINE) using the keywords calcinosis, calcification, scleroderma, systemic sclerosis, and treatment. Results: Our patient had extensive Calcinosis, Raynaud, Esophagitis, Sclerodactyly, telangiectasia (CREST)-related calcinosis, frequently ulcerating and painful. Following 2 rituximab courses (consisting of 4 weekly infusions, 375 mg/m(2) each), calcinosis significantly improved and pain disappeared. Pharmacologic agents used in the treatment of SSc-associated calcinosis include diltiazem, minocycline, warfarin, biphosphonates, and intravenous immunoglobulin. Other therapeutic approaches include surgical excision, laser vaporization, and extracorporeal shock wave lithotripsy. Conclusions: Evidence for all existing therapies is weak and therefore larger scale controlled studies are needed. Rituximab appears as a promising treatment especially in view of recent evidence that this therapy may be also effective in the underlying disease. (C) 2012 Elsevier Inc. All rights reserved. Semin Arthritis Rheum 41:822-829

引用

页码：822 / 829

页数：8