Treatment of calcinosis universalis with low-dose warfarin.

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.

• 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)

Chemical References

• Warfarin

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)