Medicina

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    Lupus Eritematoso Sistémico
    (Universidad Técnica de Ambato-Facultad de Ciencias de la Salud-Carrera Medicina, 2016-05-01) Acosta Yánez, Gabriela Carolina; Dr. Lituma Jumbo, Rosalina de Lourdes. Rosalina de Lourdes.
    Systemic Lupus Erythematosus (SLE) is a chronic autoimmune in nature and unknown etiology inflammatory disease, which is characterized by both cellular damage and tissue and where there initially affectation of a single organ which may become multisystem due to the presence autoantibody, studying with a broad spectrum of clinical manifestations in patients where most follow a chronic course and experiencing outbreaks or disease exacerbations, with periods of inactivity. This case report, examines a female patient of 15 years 6 months old, mixed, Catholic, teenage mother, ORh +; APP of preeclampsia and AQx of Caesarea (06-11-2014) by SFA. Who after 7 months (26-06-2015), it is transferred from Mobile Hospital H.R.D.A. by sudden onset of two weeks of evolution characterized by fatigue, oliguria and edema of MsIs, later progressing to anasarca. Physical examination in the Emergency (01-07-2015) somnolent tachycardia is documented patient + points urethral positive + means globoso abdominal + edema MsIs +++ / +++ and facial. So entering the Internal Medicine specialty of Nephrology (02-07-2015) is decided, it is valued for treating and results of laboratory tests and imaging performed have a IDg: ERC Stadium 3b + Mixed Syndrome + Glomerulonephritis Membranoproliferative + + D/C LES. Suspecting "LES" starts with Methylprednisolone IV (corticosteroids 2/3) + Omeprazole IV (Protector Gastric); Losartan VO (antihypertensive). Immunological tests reported LES Active was performed, and added Calcium VO 10: 00-16: 00 and lunch VO + Prednisone VO (steroid) + Hydroxychloroquine VO (Antimalarial) + ASA VO (AAP). So CFM is administered every two weeks; and after presenting ascites is added to HD tri-weekly treatment. It also features 3 occasions generalized tonic-clonic seizures so it gets Carbamazepine IV + Phenytoin VO (anticonvulsants). It adds to treatment, patient clinic and imaging tests Ceftriaxone (antibiotic therapy 7/7). Is I/C Hematology (27-07-2015), who Dg: Pancytopenia Secondary and prescribes: Stand with FECGM + Fluconazole VO (Antifungal) + Control BH and reticulocytes in 39 days. Also to Dermatology (29-07-2015), by intense itching in generalized petechial lesions that are distributed in MS -MI, who Dg: Urticaria Papulosa and prescribes: Keep corticosteroid and antihistamine + betamethasone (cream) + general measures, arising clinical improvement at the site of injury and is discontinued (05-08-2015). Nephrology graduated after 38 days of hospitalization (08-07-2015) presented good clinical evolution are corroborated by laboratory tests so it was decided to continue with monthly management controls CFM + C/E of different specialties. He goes to them promptly and after presenting rrecuperación renal function + favorable clinical currently has deferred DPA to second order, also should continue under control by C/E with different specialties, without forgetting their usual medication and general measures for adequate improvement and control of the disease.