ALPROSTADIL (PGE-1) AND CYCLOSPORINE-A IN THE TREATMENT OF RHEUMATOIDIMMUNOVASCULITIS (CASE-REPORT)

A 56-year old female patient with rheumatoid arthritis and histologica lly verifiable vasculitis with necrosis around the nail bed and distal phalanx gangrene on both hands as well as skin ulcers on both thighs was treated over 16 weeks with Cyclosporin A, glucocorticoids and Alpr ostadil. This immunosuppressive therapy resulted in a clinically relev ant improvement of acral microperfusion with complete remission of nai l bed necrosis and of gangrenous distal phalanxes. Due to improved tis sue perfusion the deep ulcers on both thighs could granulate and were closed by proliferative connective tissue, and the high-positive immun ological para meters CIC, CRP and the number of activated T-cells norm alized.