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Research Article Open access CC BY 4.0

High-Dose Intravenous Epoprostenol and Adjunct Therapies for Refractory Raynaud’s Phenomenon Associated with Anti-Jo-1 Antibodies: A Case Report

Andy Pan, Imran Khan, Marlene Mansour, Bernadett Kovacs, Caitlin Richler, Christine Landry, Kimberley Do, Sydney Morin, Deb Purkayastha, Melissa Varsava, Emma Baun, Pierre Thabet

International Journal of Medical and Pharmaceutical Case Reports · pp. 13–20 · Published 30 Jan 2025

10.9734/ijmpcr/2025/v18i1408

Abstract

This case report highlights the use of intravenous high-dose Epoprostenol for managing severe digital ischemia in a patient diagnosed with antisynthetase syndrome (ASyS) exhibiting anti-Jo1 antibodies positivity, emphasizing its vasodilatory benefits and challenges with tolerability at higher doses. A multi-modal treatment strategy, including calcium channel blockers, phosphodiesterase inhibitors, hyperbaric oxygen therapy, and prostacyclin analogs, was critical for optimizing outcomes in refractory Raynaud’s phenomenon. This case underscores the importance of individualized treatment regimens and the need for ongoing monitoring and adjustments to balance therapeutic efficacy with patient safety. The report contributes to the limited literature on the management of severe digital ischemia in ASyS and emphasizes the potential role of adjunct therapies in improving patient outcomes.

Antisynthetase syndrome digital ischemia adjunct therapies hypotension

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