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Raynaud Case Summary

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Treatment: Management is mostly symptomatic. Raynaud's phenomenon can be treated with calcium channel blockers while proton pomp inhibitors are given for gastric reflux. Low doses of corticosteroids with immunosuppressive agents may be needed in cases with progressive lung fibrosis. Pulmonary vasodilators are given in case of pulmonary arterial hypertension.(17) Regarding lung involvement in Systemic Sclerosis,the decision about whether to start treatment or not is often the most difficult challenge for the pulmonologists. Patients having a short duration of disease with recent deterioration in DLCO are candidates for immunosupressive therapy.(71) Various drugs including …show more content…
Anti-fibrosing treatments have failed to demonstrate any benefit and cyclophosphamide, which has been used for many years ,has been evaluated in two prospective randomised studies which showed a significant but modest effect on pulmonary function. (72) A multicenter, prospective, randomized, double-blind, placebo-controlled trial of corticosteroids and intravenous cyclophosphamide(CYC) followed by oral azathioprine for the treatment of pulmonary fibrosis in scleroderma did not demonstrate significant improvement in the primary or secondary end points(Primary outcome measures were change in percent predicted forced vital capacity and change in DLCO,secondary outcome measures included changes in appearance on HRCT and dyspnea scores) in the active treatment group versus the group receiving placebo.(73) Many of the

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