Abstract |
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 placebo. No patient had a change 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.
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Authors | R G Berger, G L Featherstone, R H Raasch, W H McCartney, N M Hadler |
Journal | The American journal of medicine
(Am J Med)
Vol. 83
Issue 1
Pg. 72-6
(Jul 1987)
ISSN: 0002-9343 [Print] United States |
PMID | 3605184
(Publication Type: Clinical Trial, Controlled Clinical Trial, Journal Article)
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Chemical References |
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Topics |
- Bone and Bones
(diagnostic imaging)
- Calcinosis
(diagnosis, drug therapy, etiology)
- Dermatomyositis
(complications)
- Double-Blind Method
- Drug Evaluation
- Humans
- Radiography
- Radionuclide Imaging
- Random Allocation
- Scleroderma, Systemic
(complications)
- Skin Diseases
(diagnosis, drug therapy, etiology)
- Time Factors
- Warfarin
(administration & dosage, adverse effects)
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