Reversal of Vascular and Renal Crises of Scleroderma by Oral Angiotensin-Converting-Enzyme Blockade

Abstract

UNTIL successful medical management of scleroderma crisis was reported,1 2 3 4 bilateral nephrectomy was thought to be the only therapy to control this emergency and permit survival.5 6 7 We report here two cases of dramatic reversal of scleroderma vascular and renal crises with the oral angiotensin-converting-enzyme inhibitor SQ 14225 (Captopril).8 , 9 Case Reports Case 1. Scleroderma was diagnosed in a 33-year-old woman in 1976. In 1977, a hospital evaluation revealed that her blood pressure was 120/80 mm Hg, serum creatinine 0.8 mg per 100 ml, creatinine clearance 86 ml per minute, urinary protein less than 100 mg per 24 hours, plasma renin activity 2.0 . . .