Respiratory failure in systemic sclerosis.

IF 3.2 3区 医学 Q2 RHEUMATOLOGY Rheumatology International Pub Date : 2024-11-01 Epub Date: 2023-10-14 DOI:10.1007/s00296-023-05482-4
Joaquim Ivo Vasques Dantas Landim, Andre Silva Franco, Percival Degrava Sampaio-Barros, Renata Miossi, Ana Cristina Medeiros-Ribeiro, Rosa Maria R Pereira, Ana Paula Luppino Assad
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Abstract

Systemic sclerosis (SSc) can lead to dyspnea and respiratory failure through multiple mechanisms, making a precise diagnosis particularly challenging, especially amid the current COVID-19 pandemic. In this report, we present a case involving a 26-year-old female who had previously undiagnosed SSc. She experienced acute respiratory failure necessitating orotracheal intubation. Following an extensive evaluation, the patient exhibited skin thickening, kidney failure, thrombocytopenia, microangiopathic anemia, and an antinuclear antibody with a nuclear fine speckled pattern at a titer of 1:320. A diagnosis of SSc complicated by scleroderma renal crisis (SRC) was established. The patient's condition improved after undergoing hemodialysis, receiving an angiotensin-converting enzyme inhibitor, and undergoing cyclophosphamide treatment. Subsequently, she demonstrated sustained improvement during a follow-up period of 20 months.

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系统性硬化症的呼吸衰竭。
系统性硬化症(SSc)可通过多种机制导致呼吸困难和呼吸衰竭,这使得精确诊断尤其具有挑战性,尤其是在当前新冠肺炎大流行的情况下。在本报告中,我们介绍了一例涉及一名26岁女性的病例,她之前患有未确诊的SSc。她经历了急性呼吸衰竭,需要经口气管插管。经过广泛的评估,患者表现出皮肤增厚、肾衰竭、血小板减少、微血管病性贫血和具有核细斑点图案的抗核抗体,滴度为1:320。对合并硬皮病肾危象(SRC)的SSc进行了诊断。患者在接受血液透析、接受血管紧张素转化酶抑制剂和环磷酰胺治疗后病情有所改善。随后,她在20个月的随访期间表现出持续改善。
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来源期刊
Rheumatology International
Rheumatology International 医学-风湿病学
CiteScore
7.30
自引率
5.00%
发文量
191
审稿时长
16. months
期刊介绍: RHEUMATOLOGY INTERNATIONAL is an independent journal reflecting world-wide progress in the research, diagnosis and treatment of the various rheumatic diseases. It is designed to serve researchers and clinicians in the field of rheumatology. RHEUMATOLOGY INTERNATIONAL will cover all modern trends in clinical research as well as in the management of rheumatic diseases. Special emphasis will be given to public health issues related to rheumatic diseases, applying rheumatology research to clinical practice, epidemiology of rheumatic diseases, diagnostic tests for rheumatic diseases, patient reported outcomes (PROs) in rheumatology and evidence on education of rheumatology. Contributions to these topics will appear in the form of original publications, short communications, editorials, and reviews. "Letters to the editor" will be welcome as an enhancement to discussion. Basic science research, including in vitro or animal studies, is discouraged to submit, as we will only review studies on humans with an epidemological or clinical perspective. Case reports without a proper review of the literatura (Case-based Reviews) will not be published. Every effort will be made to ensure speed of publication while maintaining a high standard of contents and production. Manuscripts submitted for publication must contain a statement to the effect that all human studies have been reviewed by the appropriate ethics committee and have therefore been performed in accordance with the ethical standards laid down in an appropriate version of the 1964 Declaration of Helsinki. It should also be stated clearly in the text that all persons gave their informed consent prior to their inclusion in the study. Details that might disclose the identity of the subjects under study should be omitted.
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