Abstract
Sympathetic hyperactivity cannot be implicated in the peripheral vascular disturbances in patients with generalized scleroderma. On the contrary, there seems to be some evidence for a sympathetic hypoactivity in these patients and there seems to be good reason to abandon sympathectomy in the treatment. Vasodilator drugs can be hazardous in late-stage scleroderma due to the possibility of redistribution of blood flow and a decrease in systemic blood pressure. Even a small decrease in systemic blood pressure severely affects blood flow in the low pressure vascular bed found in fingertips of patients with generalized scleroderma.
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