PRIMARY DIAGNOSTICS OF CYSTIC FIBROSIS IN A 10-YEARS-OLD CHILD (CASE REPORT)
About the author:
Tsvirenko S. M., Pokhylko V. I., Voloshyna V. V., Zhuk L. A., Artiomova N. S., Riabeka T. I.
CLINICAL AND EXPERIMENTAL MEDICINE
Type of article:
Cystic fibrosis is a hereditary multisystem exocrine pathology with an autosomal recessive type of inheritance, characterized by secretion of increased viscosity, which causes obstruction of the excretion ducts, with subsequent development of secondary progressive pathological changes (functional deficiency, fibrosis) of organs, especially lungs and gastrointestinal tract. According to WHO, this disease is the most widespread hereditary pathology. The article presents a clinical case of primary diagnosis of cystic fibrosis in a child of school age. The peculiarity of this study consists in the fact that this disease is most often diagnosed in newborn babies or at an early age. Conducting diagnostic tests for cystic fibrosis in children of school age is not a priority in the doctor’s practice. The present clinical observation is of interest because in a 10-year-old child at the time of the primary specific examination for cystic fibrosis, the presence of a heterogeneous space-occupying formation of the right ileal area sized 44×44×55 mm with the involvement of intestinal loops was detected, which required differential diagnostics with neoplasm. Obtaining positive results in cystic fibrosis testing justified the prescription of a specific treatment in accordance with the unified clinical protocol (Order of the Ministry of Public Health of Ukraine No. 723 as of July 15, 2016), which included a diet, pancreatic enzymes, antibiotics, mucolytics, ursodeoxycholic acid, symptomatic treatment. As a result of treatment, the child’s condition improved significantly, positive dynamics in the body weight, local manifestations of pulmonary lesion, and normalization of defecation has been observed. The ultrasound data of the abdominal cavity in the dynamics indicated the absence of a formation in the intestine after 10 days of specific treatment. In our opinion, such a formation in the intestinal loops is not specific for cystic fibrosis due to the viscous secretion of the gastrointestinal tract glands. Thus, our clinical case of primary diagnosis of mucoviscidosis in a 10-years-old child, suggests that doctors’ alertness for cystic fibrosis should not be limited to the period of infancy. The combination of pathology of the respiratory system, gastrointestinal tract, and delayed physical development gives ground for diagnostic measures in older patients.
cystic fibrosis, children, diagnostics
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Publication of the article:
«Bulletin of problems biology and medicine» Issue 1 Part 2 (143), 2018 year, 219-223 pages, index UDK 616.37-008.6-07-053.2"465*10"