Use of warfarin therapy at a target international normalized ratio of 3.0 for cutaneous polyarteritis nodosa - 24/04/13
, Yoshinao Soma, MD, PhD
Reprint requests: Tamihiro Kawakami, MD, PhD, Department of Dermatology, St. Marianna University School of Medicine, 2-16-1 Sugao, Miyamae-ku, Kawasaki, Kanagawa 216-8511, Japan.Abstract |
Background |
Cutaneous polyarteritis nodosa (CPN) is an uncommon disorder that can be difficult to manage effectively. We have previously suggested that CPN might be associated with the presence of anti-phosphatidylserine-prothrombin complex (anti-PS/PT) antibodies, members of the antiphospholipid antibody family.
Objective |
To evaluate clinical manifestations and effective treatments of CPN.
Methods |
We conducted a retrospective analysis of three patients with CPN who responded to warfarin therapy. IgG and IgM anti-PS/PT antibodies were measured with a specific enzyme-linked immunosorbent assay.
Results |
There was a dramatic improvement in our three CPN patients following warfarin therapy adjusted to a target international normalized ratio (INR) of about 3.0. Active disease progression was halted by sustained warfarin therapy during which the patients experienced resolution of their skin manifestations.
Limitations |
A small number of cases were studied and the study design was retrospective.
Conclusion |
We propose that warfarin therapy at a target INR of roughly 3.0 could be effective for treating patients with CPN. We further believe that treatment with warfarin led to the effective attenuation of anti-PS/PT antibodies related to prothrombin, and improved the symptoms in our CPN patients.
Le texte complet de cet article est disponible en PDF.Key words : anti-phosphatidylserine-prothrombin complex antibody, anti-phospholipid antibodies, cutaneous polyarteritis nodosa, international normalized ratio, warfarin
Abbreviations used : APS, CPN, INR, PS, PT, UVA
Plan
| Funding sources: None. |
|
| Conflicts of interest: None declared. |
Vol 63 - N° 4
P. 602-606 - octobre 2010 Retour au numéro
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