Limited Form of Systemic Sclerosis Improved With Enalapril

Francisco S. Martinez-Deben, MD; Pascual Sesma, MD; Juan A. Garrido, MD
Arch Intern Med. 1992;152(12):2506-2507. doi:10.1001/archinte.1992.00400240118023.
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To the Editor.—  Systemic sclerosis is a chronic, often progressive disease with no definite treatment at the present moment. The limited form has some clinically distinctive characteristic and a rather better prognosis, but some form of effective therapy is lacking too.1 Recently, we have assayed, in one patient, a rather new modality of therapy, the angiotensin-converting enzyme inhibitor enalapril, a widely available, low-toxic drug, with fairly good results.

Report of a Case.—  A 33-year-old woman presented with joint pain and swelling. Two years before, she began to experience arthralgia, principally in the hands, wrists, and knees. Later, articular swelling, morning stiffness, and Raynaud's phenomenon appeared. She developed leg edema, with pain on squatting and impossibility to complete handgrip. She smoked 20 cigarettes a day and denied alcohol consumption, illicit-drug abuse, or toxic exposure. On examination, she was a thin young woman who looked well, without cyanosis or pallor. Her


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