Clinical and Laboratory Double-blind Investigation on Effect of Fibrinolytic Therapy in Patients with Cutaneous Vasculitis

Dowling oration 1975. FIBRINOLYSIS AND VASCULITIS

“…None had systemic disturbance apart from three with mild rheumatoid arthritis. Thirteen of these patients were reported by Dodman et al (1973}. The patients were on one of three treatment regimes for 3 months. Treatment therapies included a placebo phase; 3 months phenformin (slow release) 50 mg twice daily (b.d.)…”

A painful bleeding syndrome associated with increased fibrinolytic activity

“…(2) Polycythaemia, leukaemia (Mikata et al, 1959) and cirrhosis of the liver (Grossi, Moreno & Rousselot, 1961;Fletcher et al, 1964).…”

“…The importance of these cases is to draw attention to the necessity of determining the euglobin lysis time in all cases of painful bruising, whether or not accompanied by other bleeding tendencies. Cunliflfe (1968) and Dodman et al, (1973) have drawn attention to the decreased fibrinolytic activity in certain cases of vasculitis, and have successfully treated such cases with phenformin and anabolic steroids such as ethyloestrenol or stanozolol. The cases described in this paper represent the opposite situation.…”

The cutaneous manifestations of paraproteinaemia. I

“…Neuropathies and other systemic complications have improved with combination therapy using melphelan and prednisolone, but shown no response to prednisolone alone (Ristow et al, 1976). The role of fibrinolytic therapy with phenformin and Orabolin (Dodman et al, 1973) or antiplatelet therapy with aspirin or dipyrimadole (Turpie & Hirsch, 1978) in the treatment of systemic vasculitis is still controversial. An obvious way of removing paraproteins from the circulation is plasmapheresis.…”