多系统异常子宫出血1例报告

Dr. Niranjani S, Dr. T.G. Revathy, Dr. Varrshine.R
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摘要

自身免疫性疾病是一种攻击免疫系统并导致系统性红斑狼疮和类风湿性疾病等多系统疾病的疾病,它启动自我导向的免疫反应,导致临床疾病,主要是产科疾病,如复发性妊娠丢失,先兆子痫是常见的。该研究旨在确定结缔组织疾病与子宫异常出血模式之间的关系。一例罕见的异常子宫出血与既往的复发性妊娠丢失的历史提出了伤员过多的月经出血在低血容量性休克状态。患者主诉2个月来全身不适、头晕、呼吸困难、心悸。她在过去2个月反复出现鼻出血,在过去15 - 20天出现食欲不振、反复呕吐等症状,面部和脸颊出现皮疹6个月。入院时血红蛋白为2.4g/dL,血小板小于1万,伴双氧体减少症。转至ICU,通过红细胞、新鲜冷冻血浆和血小板进行血流动力学稳定。随后,她接受了抗纤溶药物治疗,并通过多次输血纠正了严重贫血。多次单一供体血小板输注也完成。康复后,患者出院,建议继续使用羟氯喹。免疫失调和炎症共同导致了类风湿性疾病妇女月经紊乱的发展,在初始阶段可以通过系统的治疗计划得到很好的控制。
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Case Report On Abnormal Uterine Bleeding with Multi-System Disorders
Autoimmune disease is a condition that attacks the immune system and leads to multi-system disorders like systemiclupus erythematosus and rheumatoid disorders, which initiates self-directed immune responses that result in clinical diseases,mainly in obstetrics conditions like recurrent pregnancy loss, pre-eclampsia are common. The study aimed to identify therelationship between connective tissue disorders and abnormal uterine bleeding patterns. A rare case of abnormal uterinebleeding with a past history of recurrent pregnancy loss was presented in the casualty with excessive menstrual bleeding in astate of hypovolemic shock. The patient complained of generalised malaise, giddiness, breathlessness, and palpitations for thepast 2 months. She suffered recurrent epistaxis for the past 2 months and experienced symptoms like loss of appetite, recurrentvomiting for the past 15 – 20 days, and rashes over the face and cheeks for 6 months. Her haemoglobin was 2.4g/dL, and theplatelets were less than 10,000 with bicytopenia at the time of admission She was shifted to ICU and haemodynamicallystabilized by packed red blood cells, fresh frozen plasma, and platelets. Following this, she was treated with antifibrinolytics, andsevere anaemia was corrected with multiple PRBC transfusions. Multiple single-donor platelet transfusions were also done. Afterrecovery, the patient was discharged with an advice to continue hydroxychloroquine. Immune dysregulation and inflammationtogether contribute to the development of menstrual disorders among women with Rheumatoid Disorders which can be wellmanaged with systematic therapeutic plans at the initial stage.
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