Effectiveness of therapy with iloprost in hand-arm vibration syndrome.
OBJECTIVE
To evaluate the efficacy and tolerance of therapy with iloprost in hand-arm vibration syndrome.


METHODS
We describe a clinical case of a male aged 53 years, who was a heavy smoker for 30 years and a mason working with vibrating tools since 1962. He presented with a history of 10 years of attacks of vasospasm, functional impairment and digital ulceration. He was diagnosed as having hand-arm vibration syndrome vascular stage 4 on the Stockholm Workshop 1986 Scale. Besides suspension from work and abstention from smoking, we began intravenous infusion of iloprost for 6 h in cycles of 3-6 consecutive days, arriving at a dose of 1.5-2.0 ng/kg/min.


RESULTS
After eight cycles, he reported significant symptomatic and functional improvement. Iloprost was seen to be efficacious: the trophic skin lesions disappeared and his microcirculatory perfusion tests improved. There were no significant side effects.


CONCLUSIONS
We suggest that the use of iloprost in the treatment of the most advanced stages of vascular hand-arm vibration syndrome warrants further study
Meloni
Michele
M
Department of Public Health, University of Cagliari, Italy.
Torrazza
Mario
M
Ledda
Roberto
R
D001132:Arm / Q000098:blood supply; D001134:Arm Injuries / Q000188:drug therapy* / Q000503:physiopathology; D006225:Hand / Q000098:blood supply; D006230:Hand Injuries / Q000188:drug therapy* / Q000503:physiopathology; D006801:Humans; D016285:Iloprost / Q000008:administration & dosage*; D007262:Infusions, Intravenous; D008297:Male; D008833:Microcirculation; D008875:Middle Aged; D009784:Occupational Diseases / Q000188:drug therapy* / Q000503:physiopathology; D016896:Treatment Outcome; D014665:Vasodilator Agents / Q000008:administration & dosage*; D014732:Vibration / Q000009:adverse effects*
D014665:Vasodilator Agents; D016285:Iloprost