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March 1989

Control of Hypertension and Reversal of Renal Failure in Undifferentiated Connective Tissue Disease by Enalapril

Author Affiliations

From the Departments of Medicine (Drs Strongwater and Stoff), Divisions of Rheumatology and Immunology (Dr Strongwater) and Renal Medicine (Dr Stoff), and Pathology (Dr Galvanek), University of Massachusetts Medical Center, Worcester, and Brigham and Womens Hospital (Dr Galvanek), Boston.

Arch Intern Med. 1989;149(3):582-585. doi:10.1001/archinte.1989.00390030070013

• Activation of the renin angiotensin system is important in the development of accelerated hypertension and progression to acute renal failure in scleroderma and undifferentiated connective tissue disease. Inhibition of angiotensin-converting enzyme activity may effectively control blood pressure and ameliorate renal insufficiency. To our knowledge, we describe the first reversal of dialysis-dependent renal insufficiency by enalapril maleate and recovery and maintenance of near-normal renal function in a patient suffering from undifferentiated connective tissue disease with sclerodermatous features. The pathophysiologic mechanisms and long-term treatment implications with angiotensin-converting enzyme inhibitors in this setting are discussed.

(Arch Intern Med 1989;149:582-585)

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