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By Ronald M. Davis, M.D.,
Report of Two Cases
OxyFile #438
The Reversal of Scleroderma Report of Two Cases
Description: The procedures used for the arresting of the progress of
two cases of severe scleroderma and the return of the patients to near
normal health and activity. One patient was treated with intravenous
EDTA and DMSO, and with oral anti-amoebics, the other patient with
intravenous EDTA and DMSO, alternating with intravenous H202, and oral
anti-amoebics.
Title: The reversal of scleroderma(progressive systemic sclerosis),
report of two cases.
Davis, RM
Abstract: This is a report of the reversal of two cases of scleroderma,
the first case that of a fifty year old white female with severe kidney
involvement, treated with intravenous EDTA and DMSO therapy, and
Metranidazole and Allopurinol tablets(according to the Rheumatoid
Disease Foundation protocol). The second case is of a fifty-five year
old Mexican female with early disease, but having rather severe
involvement of the hands, face, and arms. She was treated with a
combination of intravenous EDTA & DMSO therapy, alternating with
intravenous H202(0.03%). Metranidazole and Allopurinol tablets were
also used with this patient. The response of these patients to the
described therapies is outlined in this report. Conventional therapies
had failed in both patients.
Scleroderma is among the connective tissue diseases, which include
systemic lupus erythematosus, rheumatoid arthritis, polymyositis-
dermatomyositis, Sjogrens Syndrome, and mixed connective tissue
disease. They are characterized by chronic inflammation, and a
dysfunctional immune system, involving joints, serosal membranes,
connective tissue and blood vessels in multiple organs (1). Kidneys and
lungs are the organs most commonly affected.
The standard treatment for scleroderma consists of large doses of
steroids and methotrexate as well as other anti-cancer agents and gold
therapy. These treatments, while at times do offer some relief from the
disease, are attendant with unwanted, severe, and sometimes fatal side
effects. Death due to the ravages of the disease is the eventual
outcome, although some cases of spontaneous remission have been
reported, they are very rare.
Case 1. This first case of scleroderma was a forty-nine year old lady
who had been told by her rheumatologist at the Houston Medical Center,
that there was nothing more he could do for her. The patient was
terminally ill and she wanted to take our therapy, as she had been
given no hope of recovery.
The patient first began to notice a sensation of swelling and tightness
of the skin, face, and extremities approximately two years prior to
being seen in our office May 22,1984. These symptoms rapidly progressed
to the point of rendering the patient unable to walk, or do daily
household work. Evidently her kidneys had become affected early in the
disease, as hypertension and headache were early symptoms. The patient
had been on antihypertension medication for over one year, and on
peritoneal dialysis for nearly nine months, before being seen in our
office. She was under the care of a rheumatologist in Houston, and the
Texas Kidney Institute at Hermann Hospital in Houston.
Medications being taken as of May 22, 1984:
Dialome - 1 t.i.d.
Compazine -25 Mg. tabs i. q.i.d. for nausea.
Capoten - 75 Mg. i. b.i.d.
Prednisone - 5 Mg i. daily.
Catapres - o.1 Mg 1 @ hs.
Peritoneal dialysis with 1 liter of solution(prepared by The Texas
Kidney Institute at Hermann Hospital) in Houston.
Physical Examination:
BP 140/90 P 94 T 100/O R 20 Ht 60" Wt 109#
The patients´ skin was white and glistening, and appeared to have been
stretched tightly over the bony skeleton. The joints at the elbows,
wrists, knees, and ankles very difficult to move. The fingers were
fixed in flexion and could not be moved at all. She had the classic
Mauskopf face.
Initial Laboratory Data:
Hgb. WBC Ca++ BUN Creat. Gluc. Trig. Uric A. SGOT SGPT Prot. Alb.
8.4 7400 9.3 91 8.3 113 377 6.6 28 23 7.0 3.7
Glob. LDH Phos. 24hr Creat Cl. Na+ K+ Cl- Co2
3.3 204 4.6 7.0 140 5.0 100 24
Urinalysis: S.G.1.010 Ph 5.0 Prot. 1+ Gluc. - Casts 2+rbc Bact. 1+ rbc
4-5/hpf wbc 3-4/hpf.
Chest X-ray: Negative
EKG: Sinus tachycardia, otherwise normal.
Impression: Progressive Systemic Sclerosis (Scleroderma)
Nephrosclerosis with kidney failure secondary to
scleroderma
Severe Anemia secondary to the two conditions above
Treatment Plan:
1. Anti-Amoebic therapy
2. I.V DMSO therapy
3. I.V. Chelation therapy.
4. Physical therapy as tolerated by the patient,
clinical course: On May 22, 1984 anti-amoebic therapy was initiated in
accordance with The Rheumatoid Disease Foundation protocol, which is as
follows; Zyloprim 300 Mg t.i.d. for 7 days. Flagyl 500 Mg - two tablets
A.M. and P.M. on two consecutive days a week for six weeks(2). The
patient was told to continue all current medications. She experienced
increased nausea and headache, plus she had severe joint pains as well
as increased muscular aces and pains. These symptoms were thought to be
due to a Herxheimer type reaction, for they were most bothersome
following taking the Flagyl on Tuesdays and Wednesdays.
On 7/27/84 the patient received an IV of 5cc of Rimso 50 (50% DMSO) in
500cc D5W over 3 hr. timespan, without untoward effects(3). These
infusions were continued three times weekly, increasing the Rimso 50 by
10cc per treatment until the maximum dose of 50cc of Rimso 50 was
reached. This dosage was decided upon following a telephone
conversation with Dr. Stanley Jacob of the University of Oregon, this
being his protocol for the treatment of scleroderma(8/27/84).
By the fourth month of therapy, the Prednisone had been gradually
withdrawn and discontinued, kidneys regaining function and patient able
to walk without assistance. Seven months after the initiation of
therapy, enough kidney function had returned to allow stopping
dialysis. The patient was feeling well and appeared well in all
respects. She still had some restriction of motion of the fingers, but
was improving steadily, and skin had lost its shiny slick look.
One year after beginning therapy, the patient´s condition had improved
to the point that it was felt we could begin adding EDTA to the
infusions. This was done 5/30/85, at which time 1cc of EDTA was added
to the iv as was 15cc ascorbic acid, and 2cc B-6, and given over three
hours. No side effects were noted. Pts. Creat. was 2.8, her clearance
was 21.7.
The EDTA was gradually increased to 8cc as the patients kidney function
continued to improve. She continued improving on treatments monthly
until she pronounced herself "cured" on 10/1/87. She has been on only
one medication since that time, that medicine being Capoten 75Mg i.
daily and Catapres 0.1 Mg @ Hs. The patient is leading an active,
normal life.
Case 2: This fifty-five year old Mexican female presented with
tightness and swelling of face, hands, arms and feet. Her symptoms
began approximately one year prior to coming to our office. She had had
surgery on the right wrist for carpal tunnel syndrome in December 1990.
She was supposed to have the other wrist operated on too, but since she
did not improve after the first surgery, it was decided not to operate
on the other wrist. She was being treated at Lyndon B. Johnson Hospital
in Houston, Texas.
Medications being taken 8/12/91.
1. Acetaminophen w/codeine #3 2 tabs q 4-6 hrs. prn pain.
2. Tylenol 5oo Mg. 1 tab q 4 hrs.
3. Pen V-K tabs 250Mg. 1 tab q 6 hrs.
4. Cephalexin 250 Mg. caps 1 capsule q 6 hrs.
5. Procardia caps, 10Mg. 1 capsule t.i.d.
6. Hydroxyzine 250Mg. tabs 1 tab q 4-6 hrs. prn itching.
7. Cuprimine 250Mg. caps 1 cap b.i.d.
8. Ibuprofen 400Mg. caps 1 tab t.i.d.
9. Flexeril 10Mg. tabs 1 tab b.i.d.
10. Tagamet 300Mg. tabs 1 tab q.i.d.
11. Zantac 150Mg. tabs 1 tab b.i.d.
Physical Exam:
BP 120/80 P 74 T 99 R 16 Ht. 62" Wt. 178#
Physical findings were limited to the skin and joints. There was
difficulty moving the hands and fingers. The fingers were fixed in a
mild degree of flexion and patient was unable to close her fists. The
skin of the hands and arms, to the mid humerus level was darkened and
very firm and painful to the touch. The feet and toes were similar to
the hands, as the toes could not be moved, and were edematous. The
patient´s skin of the feet and legs to her knees was of a darkened
color similar to the arms. The skin of arms and legs had a glistening,
shiny, slick appearance.
Laboratory Data:
Done at LBJ Hosp. 8/12/91
Pulmonary function study was normal.
Blood studies, serum electrolytes, smac 28 were wnl.
Hgb 11.8 Hct 35.6 ESR 50 RA neg ANA Pos 1:320 Speckled pattern
Sjogren Antibodies A and B negative
Scleroderma antibodies Pos 1:640
X-rays Barium swallow negative Chest X-ray Mild cardiomegaly.
EKG Not done
Impression:
1. Progressive Systemic Sclerosis (Scleroderma).
2. Carpal Tunnel Syndrome, secondary to scleroderma,(operated);
3. Anemia, mild, secondary to 1
3. Possible mild asymptomatic cardiomyopathy secondary to 1.
Treatment Plan:
1. Anti-Amoebic therapy
2. I.V. Chelation-Dmso Therapy.
3. I.V. Hydrogen Peroxide Therapy.
4. Physical Therapy as tolerated by the patient.
5. MSM p.o. q.id.
Clinical Course: The ant-amoebic therapy was started on 8/14/91.
Moderate Herxheimer reaction was noted on the first two episodes of
taking the medication, but was hardly noticeable the next four
treatment episodes. At the same time, iv infusions of chelation-DMSO
were started and continued three times weekly. There was gradual but
quite evident improvement in the patients condition over the next year.
In September 1992, iv H202 was started three times weekly instead of
the chelation-Dmso infusions. 2.5cc of 3% H202 in 250cc D5W, with 1.6cc
NaHCO3 was the formula used in the treatment(4). This was a 0.03%
solution of H202.
The response to this therapy was immediate and dramatic, as the patient
began to have softening of the tissues of the hands, arms, feet, and
legs almost within the first week of treatment. She stated that the
peroxide treatment made her "itch on the inside" of her hands, arms and
feet, but the next day after the infusion she felt a lot better. She
felt that the peroxide infusions were giving much better results than
the chelation-Dmso infusions. Her condition continued to improve with
each infusion and between infusions, even when she went 2-3 months
between treatments. She has had a total of 80 chelation-DMSO infusions
and 30 H202 infusions, and her condition is continuing to improve. The
skin of her face, arms, hands, legs, and feet is normal in appearance
and texture. She no longer has fatigue and maalaise, and her energy and
activity levels are normal. She has normal function of her hands and
fingers, and is without pain.
Discussion:
There seemed to be a better response of the second patient
to H202 therapy than the chelation-DMSO therapy. It is difficult to
compare the two cases, for the lady in case 1 was more acutely ill with
systemic disease, which the lady in case 2 did not have, however their
overall responses to treatment was excellent, albeit quite different.
It was the patient in case two´s opinion, and my opinion that the H202
infusions were superior to the Chelation-DMSO infusions. I shall
continue to use both therapies, but will begin with H202 infusions, as
well as the anti-amoebic therapy in the future.
REFERENCES
1. Mukerji Baasanti, Alpert Martin A. Hardin Joe G When the lungs are
involved by connective tissue disease. Postgraduate Medicine
1993;94(5):147
2. DI Fabio,A Rheumatoid Diseases CURED AT LAST Franklin TN,1982
Rheumatoid Disease Foundation Rt. 4 Box 137 Franklin TN 37064
3. Halstead BW, Youngberg S. The DMSO Handbook Colton CA 1981 Golden
Quill Publishers Inc. P.O Box 1278 Colton CA 92324
4.Farr CH Workbook on Free Radical Chemistry and Hydrogen Peroxide
Metabolism including protocol for the intravenous administration of
hydrogen peroxide Oklahoma City OK 1989 IBOM Foundation P.O. Box 891954
Oklahoma City, OK 73189
5. Cranton EM, Bypassing Bypass Medex Publishers Inc. Ripshin Rd., P.O.
Box 44 Troutdale VA 24378-0044 1982
6. Halstead BW The Scientific Basis of Chelation Therapy, Colton, CA
1979 Golden Quill Publishers Inc. P.O. Box 1278 Colton CA 92324
7. Cranton EM A Textbook on EDTA Chelation Therapy J of Adv Med 2(1/2)
1989
8. Douglas WC Hydrogen Peroxide MEDICAL MIRACLE Atlanta GA 1992 Second
Opinion Publishing P.O. Box 467939 Atlanta GA 30346-7939
Author: Ronald M. Davis, M.D. 5002 Todville, Seabrook, TX 77586
Acknowledgements:
Stanley W. Jacob, M.D., Oregon Health Sciences Univ. Portland OR. For
his time and explanation of his DMSO protocol, and for seeing pt. 1 in
consultation.
Charles H. Farr MD, PhD , for the many interruptions in his busy
schedule, to assist in the care of both of the patients, with answering
questions about protocols of EDTA, DMSO, and H202 therapies.
Garry Gordon, MD 5335 Compass Tempe AZ 85283 without whose help I would
probably not have gotten involved in chelation and other alternative
therapies.
Katy Thompson, M.D., Texas Kidney Institute, Hermann Hospital, Houston,
Texas for her kind assistance and co-operation in the care of the
patient in case 1
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