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April 14, 1978

Minoxidil in Scleroderma With Hypertension

Author Affiliations

Bowman Gray School of Medicine Winston-Salem, NC

JAMA. 1978;239(15):1494. doi:10.1001/jama.1978.03280420030014

To the Editor.—  Gavras and his associates1 without naming the agent have suggested that a new potent vasodilator might be given in combination with β-adrenergic blockade to patients with what might be called malignant scleroderma because of the acute hypertensive process characteristic of the disease. We report our experience with such a patient given propranolol and minoxidil.

Report of a Case.—  A 47-year-old man was hospitalized May 6, 1976, because of a flu-like syndrome and hypertension for a month. During the preceding year he had been abnormally sensitive to cold, and dry gangrene had developed on the tips of his right thumb and first and second fingers. When seen by us, he exhibited a grade 4 Keith-Waggoner hypertensive retinopathy, cardiomegaly, evidence of Raynaud's phenomenon, microangiopathic anemia, thrombocytopenia, nephrotic syndrome (24-hour proteinuria was 6.8 g), and creatinine clearance of 3 ml/min. Before treatment his blood pressure hovered at 220/130 mm