BACKGROUND:Extracorporeal photochemotherapy (photopheresis), an immune-modulating therapy, has been demonstrated to elicit a therapeutic response in the treatment of several autoimmune disorders. We evaluated the use of photopheresis in the treatment of patients with progressive systemic sclerosis (PSS; scleroderma).

METHODS:Five patients with early-onset, diffuse PSS were treated with photopheresis on 2 successive days monthly for an average of 59 months (range 54-89 months). We initially reported the response this group of patients had to photopheresis treatment at an average of 11 months (range 6-21 months).

RESULTS:An improvement or stabilization was noted in most patients in skin thickening, joint mobility, pulmonary function studies, oral aperture, functional index, as well as symptoms including Raynaud's phenomenon, dyspnea, fatigue, dysphagia, arthralgias, and cutaneous ulcers. Renal function tests remained within normal range. A total of 296 monthly treatments were administered without significant toxicity.

CONCLUSIONS:This study suggests that extended use of extracorporeal photochemotherapy in the management of early-onset, diffuse PSS is well tolerated and may provide an increasingly beneficial clinical outcome.

译文

背景 : 体外光化学疗法 (光疗法) 是一种免疫调节疗法,已被证明在治疗几种自身免疫性疾病时会引起治疗反应。我们评估了光导疗法在进行性系统性硬化症 (PSS; 硬皮病) 患者治疗中的应用。
方法 : 五名早发,弥漫性PSS每月连续2天接受光渗疗法治疗,平均治疗59个月 (范围54-89个月)。我们最初报告了这组患者平均11个月 (范围为6-21个月) 接受光渗疗法治疗的反应。
结果 : 大多数患者在皮肤增厚、关节活动度、肺功能研究,口腔孔径,功能指数以及包括雷诺现象,呼吸困难乏力,吞咽困难,关节痛和皮肤溃疡在内的症状。肾功能检查保持在正常范围内。每月总共进行296次治疗,没有明显的毒性。
结论 : 这项研究表明,在早期发作的治疗中,体外光化学疗法的广泛使用,弥漫性PSS耐受性良好,可能提供越来越有益的临床结果。

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