Arthritis and rheumatism
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Arthritis and rheumatism · Mar 1987
Clinical Trial Controlled Clinical TrialNicardipine in the treatment of Raynaud's phenomenon. Dissociation of platelet activation from vasospasm.
A new calcium channel blocker, nicardipine, was studied for treatment of Raynaud's phenomenon in a double-blind, placebo-controlled, crossover trial during the winter months. Clinical response was assessed by a patient-kept diary of symptoms and finger systolic pressure that was measured at room temperature and during cold challenge. In vivo platelet activation was determined by measuring plasma levels of the platelet-specific proteins, beta-thromboglobulin and platelet factor 4. ⋯ There was a reduction of plasma levels of beta-thromboglobulin and platelet factor 4 in the overall study group while taking nicardipine compared with that during the placebo period (mean change 5.0 +/- 2.4 ng/ml, P = 0.054, and 1.4 +/- 0.6 ng/ml, P less than 0.01, respectively). These results demonstrate that while nicardipine was not effective in reducing the episodes of Raynaud's phenomenon, it did inhibit in vivo platelet activation. These findings suggest that platelet activation is not the primary event in the pathogenesis of acute vasospasm in Raynaud's phenomenon, since reduction of platelet activation by the drug did not change the severity of vasospasm.
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Arthritis and rheumatism · Jul 1986
Case ReportsReflex sympathetic dystrophy syndrome: an unusual mode of presentation of osteomalacia.
We report 2 patients with reflex sympathetic dystrophy syndrome (RSDS) associated with renal tubular osteomalacia. In both patients, RSDS was the presenting manifestation. Treatment of the underlying condition with calcitriol resulted in healing in both patients. ⋯ In the group with RSDS, 1 patient (0.4%) was found to have osteomalacia of renal tubular origin. Thus, radiologic findings suggestive of RSDS are frequent in patients with osteomalacia, especially that of renal tubular origin. On rare occasions, the full-blown clinical picture of RSDS may obscure the diagnosis of osteomalacia.