Układ krążenia, a stan dermatologiczny u chorych z twardziną ograniczoną

Beata Bergler-Czop, Maria Dukalska, Władysław Rokicki, Grażyna Markiewicz-Łoskot, Anna Lis, Ligia Brzezińska-Wcisło, Teresa Bilewicz-Wyrozumska

Streszczenie
Introduction: Scleroderma is a group of diseases with fibrosis and vascular changes. Localized scleroderma, that is the most frequently connective tissue disease in children, patological changes of skin, subcutaneous tissue and muscles are observed.
Matherial and methods: The circulatory system was studied in 32 patients with diagnosis of localized scleroderma (at the age of 11 up to 31 years, age mean a 18,4 years ? 3,9), 20 females and 12 males. In Department of Pediatric Cardiology the following physical examinations were performed: electrocardiogram (ECG), 24-hour Holter ECG monitoring, a treadmill exercise test conducted according to Bruce protocol as well as echocardiography plus Doppler´s effect investigation. In Department of Dermatology dermatological state was examined by physical exam, and its changes – by interview, photos and hospital and ambulatory documents. Radiological exams of the chest, palms and upper part of alimentary canal and serum exam (ANA) were also performed.
Results: Similarly as 10 years ago, during the routine electrocardiogram (ECG), the incomplete right branch block has been found. During examination using 24-hour Holter ECG monitoring, in 80% of cases regular records were stated while in the rest of patients supraventricular and ventricular arrhythmia was disclosed. The abnormalities related to valvular function were found in 2 cases. During the exercise tests (performed according to Bruce´s protocol), only in 3 patients dysrrhythmia has been challenged. Dermatological investigations revealed the improvement of the local state in 5 patients. Aggravation was observed in 46% patients.There were no radiological changes in the patients of the study. In 6 cases ANA were disclosed.
Conclusion: Results of cardiological investigation appeared not to point at any progression of changes in the circulatory system in a group under examination during the last 10 years. Dermatological investigation in most cases suggests aggravation or no changes in time. So we think that there is no correlation between dermatological stage and cardiological changes in patients with localized scleroderma.

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