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Successful Management of a Complicated Ulcer Caused by autoimmune vasculitis, with Sildenafil Citrate in a Patient with Primary Antiphospholipid Syndrome and Transient Steroid-Induced Diabetes Mellitus: A Case Report and Literature Review

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Journal of Diabetes Mellitus 2014年第3期4卷 189-193页

作者： Fernando Grover-Paez Leonel Garcia-Benavides Ernesto German Cardona-Munoz Carlos Gerardo Ramos-Becerra Jesus Ricardo Garcia-Corral Carlos Enrique Medina-Garcia Guillermo Adrian Alanis-Sanchez Sylvia Elena Totsuka-Sutto Institute of Experimental and Clinical Therapeutics Department of PhysiologyUniversity Center of Health SciencesUniversity of GuadalajaraGuadalajaraMexico

Antiphospholipid syndrome (APS) is a prothrombotic condition that can affect both the venous circulation and the arterial system. The deep veins of the lower extremities and cerebral blood flow are the most common sites of venous and arterial thrombosis, respectively. Skin ulceration and gangrene may be associated with an active vasculitis in patients with APS. These kinds of ulcers are considered intractable because healing is difficult to achieve. Using steroids as immunesuppressant therapy is still a basic part of managing APS and vasculitis. Nevertheless, in the presence of steroid-induced diabetes mellitus, the priority is to achieve faster wound healing, because of the potential complications that can develop due to metabolic dysfunction and augmented vulnerability to infection. Until recently, there were few reports demonstrating the benefits of the use of adjuvant phosphodiesterase-5 inhibitors like sildenafil citrate in different clinical entities with courses like Raynaud’s phenomenon, scleroderma, and resistance to vasodilator therapy. We present the first report demonstrating the additional benefit of sildenafil citrate for the integration of grafts in a patient with steroid-induced diabetes and APS who had ulcers due to vasculitis resistant to the usual vasodilator therapy.

关键词： autoimmune vasculitis Sildenafil Citrate Steroid-Induced Diabetes Mellitus Primary Antiphospholipid Syndrome

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