Abstract
The article presents a complex clinical case of idiopathic recurrent pancreatitis in a young woman, 23 years old. The main clinical manifestation of the disease was acute, intense, recurrent abdominal pain. Despite ongoing symptomatic therapy, the patient’s condition had been worsened, and the intensity of abdominal pain increased. Adequate dosage of the enzyme replacement therapy allowed increasing the duration of remission. Differential diagnosis, additional laboratory and instrumental studies allowed determining the cause of recurrent pancreatitis and confirming the diagnosis of cystic fibrosis with a primary lesion of the pancreas. A distinctive feature of this clinical case is the diagnosis of a hereditary cystic fibrosis disease in adulthood, the absence of clinical symptoms of lungs’ involvement in the pathological process, as well as the absence of underdevelopment, malnutrition. The diagnosis of cystic fibrosis is confirmed by German specialists; currently, the patient continues treatment in a German clinic.
 The article presents current data on idiopathic pancreatitis, discusses a diagnostic algorithm for identification of the cause of the disease. The etiology, pathogenetic mechanisms of cystic fibrosis occurrence are considered, the known types of CFTR gene mutations, causing the development of the disease, as well as the principles of replacement enzyme therapy in patients with cystic fibrosis are described. Evidence-based medicine data are presented, revealing the efficacy and safety of taking enzyme preparations in the correction of the exocrine pancreatic insufficiency.
Highlights
Настоящую статью мы хотели бы начать с любимой загадки Авраама Линкольна, который любил задавать своим собеседникам вопрос: «Сколько лап у собаки, если хвост мы назовем лапой?»
В ходе ультразвукового исследования (УЗИ) органов брюшной полости (ОБП) 08.07.2015 отмечено увеличение размеров поджелудочной железы (ПЖ): головка — 31,5 мм, тело — 18,1 мм, хвост — 24,3 мм, а также неровность контура, диффузная неоднородность ее структуры, повышение эхогенности с наличием множественных гипоэхогенных участков, вирсунгианов проток не визуализировался
Differential diagnosis, additional laboratory and instrumental studies allowed determining the cause of recurrent pancreatitis and confirming the diagnosis of cystic fibrosis with a primary lesion of the pancreas
Summary
Вирусные (вирусный паротит, Коксаки B, гепатит B, цитомегаловирус, простой герпес, герпес зостер, ВИЧ, краснуха); Инфек- Бактериальные (легионелла, лептоспира, ционные сальмонелла, микоплазма, бруцелла);. Антимикробные препараты (метронидазол, стибоглюконат, сульфонамиды, тетрациклин, нитрофурантоин, эритромицин, изониазид);. Препараты, применяющиеся в гастроэнтерологической практике (5-аминосалицилаты, сульфасалазин, циметидин, ранитидин, меркаптопурин, ингибиторы протонной помпы);. Другие широко использующиеся препараты (анальгетики, ацетаминофен, салицилаты, сулиндак, кальций, этинил эстрадиол, нортиндрон)
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