The acute phase response in scleroderma. Differing responses to intravenous PGE1.

A defective acute phase response of scleroderma patients following intravenous PGE1 infusion has been reported. Serum C-reactive protein levels in scleroderma patients before and after a seventy-two hour infusion of either PGE1 or placebo were measured in the present study. The mean baseline serum CRP level in scleroderma patients was significantly greater than in normal controls (12 +/- 9.0 mcg/ml vs 1.4 +/- 1.7 mcg/ml) (p less than 0.001). Before the intravenous infusion, the PGE1-treated and placebo-treated groups had mean serum CRP concentrations of 14 +/- 9 and 10 +/- 9 mcg/ml, respectively. After the three-day infusion, these values were 109 +/- 75 and 11 +/- 10 mcg/ml (p less than 0.01). Scleroderma patients appeared to have two types of response to PGE1. Three patients had large increases (mean = 167 +/- 32 mcg/ml) and three had smaller increases (mean = 22 +/- 17) (p less than 0.005). The patients with greater increases had disease of shorter duration and greater cutaneous involvement. Overall, the acute phase response appears to be intact in scleroderma patients, but may differ in degree.