TREATMENT OF CALCINOSIS UNIVERSALIS WITH LOW-DOSE WARFARIN
TREATMENT OF CALCINOSIS UNIVERSALIS WITH LOW-DOSE WARFARIN
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DOI：
10.1016/0002-9343(87)90499-2
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发表时间：
1987-07-01
影响因子：
5.9
通讯作者：
HADLER, NM
中科院分区：
文献类型：
--
作者：
BERGER, RG;FEATHERSTONE, GL;HADLER, NM
继发于皮肌炎或系统性硬化症的普遍钙质沉着症患者的钙结合氨基酸、γ-羧基谷氨酸水平升高。影响谷氨酸γ羧化的酶对华法林敏感。在一项非盲初步研究中，四名普遍性钙质沉着症患者每天接受 1 毫克华法林治疗，为期 18 个月。两名患者的 99m-二膦酸锝全身核扫描显示尿中 γ-羧基谷氨酸浓度降低，骨骼外摄取也降低。在随后的双盲安慰剂研究中，每天接受 1 mg 华法林的患者中，三分之二的患者在 18 个月后骨骼外核示踪剂的摄取出现下降，而接受安慰剂的四名患者则没有出现这种情况。没有患者负责临床评估、出血并发症或基线正常凝血酶原时间。这种低剂量华法林治疗方案似乎没有明显的副作用，这些结果表明对这些风湿性疾病中钙质沉着的进展具有有益的作用。
Patients with calcinosis universalis secondary to dermatomyositis or systemic sclerosis have increased levels of the calcium-binding amino acid, gamma-carboxyglutamic acid. The enzyme that effects gamma carboxylation of glutamic acid is warfarin-sensitive. Four patients with calcinosis universalis were treated with 1 mg per day of warfarin for 18 months in a non-blind initial study. Two patients had both decreased gamma-carboxyglutamic acid urinary concentration and decreased extra-skeletal uptake on technetium 99m-diphosphonate whole-body nuclear scanning. In a subsequent double-blind placebo study, two thirds of the patients receiving 1 mg per day of warfarin had decreases in extra-skeletal nuclear tracer uptake after 18 months, compared with none of the four patients receiving placebor. No patient had a charge in clinical assessment, bleeding complication, or baseline normal prothrombin time. This low-dose warfarin regimen appears to have no demonstrable adverse effects, and these results suggest a beneficial effect on the progression of calcinosis in these rheumatic diseases.