Significant attenuation of macrovascular involvement by bosentan in a patient with diffuse cutaneous systemic sclerosis with multiple digital ulcers and gangrene

Vol.21 No.5

Case Report

Significant attenuation of macrovascular involvement by bosentan in a patient with diffuse cutaneous systemic sclerosis with multiple digital ulcers and gangrene

Authors

Yohei Ichimura¹ , Yoshihide Asano¹ , Masaru Hatano² , Zenshiro Tamaki¹ , Tomonori Takekoshi¹ , Asako Kogure¹ , Manabu Tomita¹ , Tomohiko Kawashima¹ , Miki Miyazaki¹ , Takashi Taniguchi¹ , Takehiro Takahashi¹ , Hiroshi Mitsui¹,Makoto Sugaya¹,Atsushi Yao²,Koichiro Kinugawa²,Shinichi Sato¹

Department of Dermatology, Faculty of Medicine, University of Tokyo, 7-3-1 Hongo, Bunkyo-ku, Tokyo, 113-8655, Japan
Department of Cardiovascular Medicine, University of Tokyo Graduate School of Medicine, Tokyo, Japan

Received:

7 December 2010

Accepted:

14 February 2011

Published online:

10 March 2011

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Abstract

Systemic sclerosis (SSc) is characterized by vascular injuries, and bosentan has recently been proved to be efficacious for the prevention of new digital ulcers in SSc. We herein report a case of SSc in a patient with refractory digital ulcers and gangrene treated with bosentan. Stenosis of the ulnar artery, evaluated by magnetic resonance angiography, was attenuated by the bosentan treatment, suggesting that bosentan exerts a reverse remodeling effect against the pathological organic changes of arteries in SSc.

Key words

Bosentan - Digital ulcers and gangrene - Macrovascular disease - Systemic sclerosis