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

• 作者: Carlos Enrique Medina-García Carlos Gerardo Ramos-Becerra Ernesto Germán Cardona-Mu?óz Fernando Grover-Páez Guillermo Adrián Alanis-Sánchez Jesús Ricardo García-Corral Leonel García-Benavides Sylvia Elena Totsuka-Sutto
• 来源期刊: 糖尿病(英文)
• 学科: 医学
• 关键词: Autoimmune VASCULITIS SILDENAFIL Citrate Steroid-Induced Diabetes Mellitus Primary ANTIPHOSPHOLIPID Syndrome
• 年，卷（期）: tnbyw_2014,（3）
• 页码范围: 189-193
• 页数: 5页
• 分类号: R5

摘要

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.