青少年系统性硬皮病心脏损伤(附临床病例)

L. Omelchenko, O. Mukvich, O. Belska, I. Dudka, Y. Klymyshyn, N. Rudenko, R. V. Kalashnikova, D.L. Ismakaieva, N. Vdovina, T.A. Liudvik
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摘要

青少年系统性硬化症(JSS)有许多不同于成人的临床表现。早期诊断是有问题的。疾病的病程和预后的严重程度取决于过程中内脏器官的受累程度,首先是心脏、肺、肾脏。心脏病理是成人硬皮病过程的一个常见和预后不利的目标,但它很少在儿童中被诊断出来。本研究的目的是研究严重心脏病患儿系统性硬化症的临床表现特点。一个多态性的临床症状严重心脏损害与发展扩张性心肌病在1岁儿童与系统性硬化症提出。该病例的特点是:系统性硬化症早期出现在一个自身免疫病理(父亲和祖母有牛皮癣)的沉重遗传史的儿童身上,自身免疫过程进展迅速,非紧密型(扩张型)心肌病导致的严重心脏损伤,在使用病理治疗时临床动态呈阳性。使用现代诊断方法早期发现心血管病变,在多学科团队中及时实施适当的治疗,定期进行心血管筛查,可以改善预后,提高生活质量,降低死亡率。
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Heart injury in juvenile systemic sclerodermy (clinical case)
Juvenile systemic sclerosis (JSS) has many clinical manifestations that differ from adults. Early diagnosis is problematic. The course of the disease and the severity of the prognosis depend on the involvement of internal organs in the process, first of all, the heart, lungs, kidneys. Cardiac pathology is a frequent and prognostically unfavorable target of the scleroderma process in adults, but it is rarely diagnosed in children. The aim of the work was to study the features of the clinical manifestations of systemic sclerosis in a child with severe heart disease. A polymorphism of the clinical symptoms of severe heart damage with the development of dilated cardiomyopathy in a one-year-old child with systemic sclerosis is presented. The features of the case are the early debut of systemic sclerosis in a child with a burdened hereditary history of autoimmune pathology (psoriasis in the father and grandmother), rapid progression of the autoimmune process, severe heart damage by the type of non-compact (dilated) cardiomyopathy, positive clinical dynamics when using pathogenetic therapy. Early detection of cardiovascular lesions using modern diagnostic methods, timely implementation of adequate therapy in a multidisciplinary team and regular cardiovascular screening can improve the prognosis, quality of life and reduce mortality.
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