読者です 読者をやめる 読者になる 読者になる

函館稜北病院総合診療科抄読会 #hakodoku

毎週木曜日5:30PMから30分間、Clinical Problem-Solvingを素材にクリニカル・パールを拾い集めます。

Lucky Lady

抄読会

医者の能力、病状、それにも増して重要なのが運だったりする。

【参加人数】4名

【今回の語数】2355語【累計語数】38,940語

【私の読了にかかった時間】18分25秒 (128 wpm)

【クリニカルパール】

  • When pregnancy begins during a complete remission of lupus, it is associated with a relatively low incidence of relapse. In contrast, relapse is more frequent among patients who have active disease at the time of conception, and in these patients the clinical course is often hectic and the reactivation of disease is sometimes associated with irreversible organ failure.

  • In pregnant patients with lupus, an increase in C3a is often accompanied by a decline in total C3 and total complement.

  • In 92 percent of cases, preeclampsia occurs after the 32nd week of gestation, and 75 percent of patients in whom it develops are primigravidas.
  • Flare-ups of systemic lupus are relatively frequent in the peripartum and postpartum periods.
  • The combination of fever and lung infiltration in an immunocompromised host made histologic diagnosis obligatory. The decision to proceed with bronchoalveolar lavage and, if necessary, a lung biopsy seems rational.

【感想】

  • 参加の先生から過去の "Unlucky Lady" の症例提示もありました。実臨床では、何をしてもしなくても、時間が経つと、いい結果あるいは悪い結果が出てしまう。運も大切なファクターです。