[A prospective study of plasma exchange in the treatment of diffuse scleroderma]

A prospective randomized study to compare the efficacy between plasma exchange (PE) plus D-penicillamine (13 cases) (group I) and D-penicillamine alone (16 cases) (group II) in the treatment of diffuse scleroderma was carried out. Total skin score, the distance between finger and palm, the distance between upper and lower teeth, the index of joint tenderness, grip strength, ESR, IgG, plasma renin and angiotensin II were measured. After 6 times of PE, all parameters in group I showed significant improvement as compared with those before treatment (P < 0.05-P < 0.01). The overall effective rates evaluated by physicians and by patients were 61.1% and 69.2% respectively. One and half year after the 6 times of PE, all parameters in group I were lower than those in group II (P < 0.05). In group I there were less internal organ impairment and hypertension than in group II. The commonest side effect of PE was hypotension; it disappeared after transfusion.