Treatment of severe pulmonary hypertension secondary to scleroderma: A three-drug approach

Abstract

We present a case of scleroderma complicated by severe pulmonary hypertension. The use of a three-drug (bosentan, iloprost, and sildenafil) approach contributed to significant improvement of both the clinical conditions and the pulmonary hemodynamics. Combining three pulmonary vasodilators with different mechanisms of action could benefit patients with severe pulmonary hypertension resistant to conventional therapy. © 2008 The Japanese Society of Internal Medicine.