Intestinal subocclusion and severe malnutrition in systemic sclerosis without scleroderma

Systemic sclerosis sine Scleroderma is an uncommon form of systemic compromise of this disease, in the abscense of cutaneous manifestations. We present the case of a 71 years-old woman, body mass index (BMI) in 16.9 kg/m2, with history of hypothyroidism and chronic constipation, who goes to the emer...

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Detalles Bibliográficos
Autores: Valenzuela-Rodríguez, Germán, Cabello León, Eduardo, Yoza Yoshidaira, Max, Piscoya Rivera, Alejandro
Tipo de recurso: artículo
Estado:Versión publicada
Fecha de publicación:2023
País:Perú
Institución:Universidad Nacional Mayor de San Marcos
Repositorio:Revistas - Universidad Nacional Mayor de San Marcos
Idioma:español
OAI Identifier:oai:revistasinvestigacion.unmsm.edu.pe:article/25662
Acceso en línea:https://revistasinvestigacion.unmsm.edu.pe/index.php/anales/article/view/25662
Access Level:acceso abierto
Palabra clave:Esclerodermia Sistémica
Desnutrición
Obstrucción intestinal
Scleroderma Systemic
Malnutrition
Intestinal Obstruction
Descripción
Sumario:Systemic sclerosis sine Scleroderma is an uncommon form of systemic compromise of this disease, in the abscense of cutaneous manifestations. We present the case of a 71 years-old woman, body mass index (BMI) in 16.9 kg/m2, with history of hypothyroidism and chronic constipation, who goes to the emergency with pain, abdominal bloating, and nausea. An abdominopelvic tomography was made, reporting a collapse of the gastric chamber, some segments of intestinal loops distended with signs of fecalization in the small intestine. A colonoscopy described severe dolicocolon. We observed indurated plaques in left elbow and in both buttocks. Lab tests: ANA 1/640 with anticentromeric pattern, anticentromere antibodies = 227 U/mL (0-25), Anti-SCL-70 = 1.9 U/mL (0-25), anti-RNP = 0.1 U/mL (0-25). Peri-ungueal cappilaroscopy 200x showed mega capillaries. Clinical diagnosis was systemic sclerosis sine scleroderma. We initiated treatment with a high-fiber diet and parenteral nutrition for a week. The patient evolution was favorable.