TITLE

SYSTEMIC LUPUS ERYTHEMATOSUS

AUTHOR(S)
Brandsma, Maynard; Sternberg, Thomas H.; Davis, John H.
PUB. DATE
March 1970
SOURCE
Angiology;Mar1970, Vol. 21 Issue 3, p172
SOURCE TYPE
Academic Journal
DOC. TYPE
Article
ABSTRACT
In the past the treatment of SLE has varied a great deal without much result. Antimalarial drugs have been used with mediocre results. Salicylates can be helpful in controlling muscle pains. ACTH and steroids have been most effective in controlling the inflammatory manifestations of SLE. In the case reported here, chloroquine had no result whatsoever and prednisone did not seem to improve the condition. Because her overall status was so desperate, it was felt justified to use an experimental drug such as dimethyl sulfoxide, first of all to increase the action of fluocinolone, as DMSO acts as a solvent and can be used by applying medication percutaneously with a subsequent absorption in the blood stream. When the eye symptoms developed we could not be sure if they were due to steroids or the DMSO, but they had all the earmarks of steroid toxicity as has been reported in cases developing a pseudo-tumor syndrome. For that reason we decided to continue the DMSO without further use of steroids and the patient improved rapidly. At the time of this writing, which is 3 years after all treatment was discontinued, the patient actually has no signs or symptoms of SLE and we therefore felt that she is without question in a complete remission. None of us has ever seen such as advanced case of SLE in a young woman with such a long-lasting remission. We now have two possibilities. The patient went into a remission because of the huge dosage of steroids used orally as well as percutaneously, or she improved because of the use of DMSO. Because massive steroid therapy has rarely if ever produced a complete remission such as this, we feel that a DMSO action cannot be discounted. After we terminated the treatment, the Food and Drug Administration of the United States decided to withdraw this drug for experimental use because of eye disturbances reported in animals. We were therefore unable to duplicate this in other cases but are reporting this, first of all for the rather unusual features in this case, together with the almost disastrous result of steroid treatment, and with the hope that others will have an opportunity to use dimethyl sulfoxide on these cases and see if our results can be duplicated. At the time of this writing, the patient has been completely well without symptoms and with a negative antinuclear antibody test and negative LE test and LE preparation.
ACCESSION #
16515185

 

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