title: Treatment of severe pulmonary hypertension secondary to scleroderma: a three-drug approach.
abstract: We present a case of scleroderma complicated by severe pulmonary hypertension. The use of a three-drug (bosentan, iloprost, and sildenafil) approach contributed to significant improvement of both the clinical conditions and the pulmonary hemodynamics. Combining three pulmonary vasodilators with different mechanisms of action could benefit patients with severe pulmonary hypertension resistant to conventional therapy.
authors.affiliation: San Raffaele Foundation, Cittadella della Carita, Taranto, Italy.
authors.forename: Girolamo
authors.initials: G
authors.lastname: Catapano-Minotti
authors.forename: Andrea
authors.initials: A
authors.lastname: Corsonello
authors.forename: Giovanni
authors.initials: G
authors.lastname: Guadalupi
authors.forename: Rosalia
authors.initials: R
authors.lastname: Spani
authors.forename: Raffaele
authors.initials: R
authors.lastname: Antonelli-Incalzi
mesh_terms: D000077300:Bosentan; D004359:Drug Therapy, Combination; D004562:Electrocardiography; D005260:Female; D006801:Humans; D006976:Hypertension, Pulmonary / Q000188:drug therapy* / Q000209:etiology* / Q000503:physiopathology; D016285:Iloprost / Q000627:therapeutic use*; D008875:Middle Aged; D010879:Piperazines / Q000627:therapeutic use*; D011687:Purines / Q000627:therapeutic use; D012595:Scleroderma, Systemic / Q000150:complications*; D000068677:Sildenafil Citrate; D013449:Sulfonamides / Q000627:therapeutic use*; D013450:Sulfones / Q000627:therapeutic use*; D016896:Treatment Outcome; D014665:Vasodilator Agents / Q000627:therapeutic use*
chemical_list: D010879:Piperazines; D011687:Purines; D013449:Sulfonamides; D013450:Sulfones; D014665:Vasodilator Agents; D000068677:Sildenafil Citrate; D016285:Iloprost; D000077300:Bosentan