Subsepsisallergic B Isslerafranconi: etiology, pathogenesis and treatment
Subsepsisallergichesky V Isslerafrankoni is a rare disease that is considered a special form of rheumatoid arthritis. Its etiology and pathogenesis have not been fully elucidated, but infection, often indolent focal, is a provoking factor.
The acute onset of the disease is characterized by a high temperature (38.5-39 °C), which lasts for many weeks and months, sometimes with a morning maximum and large fluctuations during the day. Typical are polymorphic skin rashes (urticarial, maculopapular, anular exudative-hemorrhagic, etc.), localized on the extremities, less often on the face, chest, and abdomen. Arthralgia or other joint damage, paroxysmal abdominal pain, enlarged lymph nodes, spleen, liver and neurovegetative disorders may also be observed.
In the initial period of the disease, hematological changes may be observed: leukocytosis with neutrophilia, with a shift of the formula to the left, a persistent increase in ESR for 3-6 months. In the future, there is a tendency towards leukopenia, ESR decreases. Characterized by hyperproteinemia, hypoalbuminemia, increased gamma globulins, increased levels of immunoglobulins M and G, and decreased serum complement.
The diagnosis is based on the history and clinical course. Differential diagnosis is carried out with rheumatism, systemic lupus erythematosus, systemic scleroderma, osteomyelitis, sepsis, and typhoid fever.
In addition to general measures (hospitalization, bed rest), antibiotics according to indications, acetylsalicylic acid is included in the complex of therapy, often in combination with brufen or voltaren. In severe cases, glucocorticoids are prescribed in combination with indomethacin or butadione. The basic drugs for treatment include drugs of the 4-aminoquinoline series (delagil, plaquenil).
The prognosis is serious; Often the disease transforms into juvenile rheumatoid arthritis. Prevention includes treatment of foci of chronic infection and hyposensitizing therapy.
Although subsepsisallergic B Isslerafranconi is a rare disease, its diagnosis and treatment are of great importance. Despite the unclear etiology and pathogenesis, it is important to take into account the infectious factor and make a differential diagnosis with other diseases. The main methods of treatment are general measures, antibiotics according to indications, acetylsalicylic acid, glucocorticoids and basic drugs.
Despite the serious prognosis and the possibility of transformation of the disease into juvenile rheumatoid arthritis, early and adequate treatment can improve the patient's prognosis and quality of life. Prevention includes treatment of foci of chronic infection and hyposensitizing therapy. Further research is needed to better understand this rare disease and develop effective treatments.