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Small intestinal complications in progressive systemic sclerosis.

M M Wilkinson

    Gastroenterology Nursing : the Official Journal of the Society of Gastroenterology Nurses and Associates
    |August 1, 1992
    PubMed
    Summary
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    This case report highlights a rare instance of progressive systemic sclerosis with intestinal involvement, leading to severe complications. Effective management required intensive nursing care and home total parenteral nutrition.

    Area of Science:

    • Rheumatology
    • Gastroenterology
    • Infectious Diseases

    Background:

    • Progressive systemic sclerosis (PSS) is a rare autoimmune disease characterized by fibrosis and vascular abnormalities.
    • Polymyositis, an inflammatory myopathy, can co-occur with PSS, complicating diagnosis and management.
    • Small intestinal involvement in PSS is uncommon but can lead to significant gastrointestinal dysfunction.

    Observation:

    • A 33-year-old woman with PSS and polymyositis presented with a beta-hemolytic Streptococcus infection of the knee.
    • The patient exhibited rare small intestinal involvement secondary to PSS.
    • Complications included malabsorption, pneumoperitoneum, and pneumatosis cystoides intestinalis.

    Findings:

    • The patient's condition necessitated home total parenteral nutrition due to severe malabsorption.

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  • Diagnostic challenges were presented by the rare combination of PSS, polymyositis, and intestinal complications.
  • Treatment required a multidisciplinary approach, emphasizing the role of nursing care.

    • Implications:

    • This case underscores the importance of vigilant monitoring for gastrointestinal complications in PSS patients.
    • Early recognition and management of infections are critical in immunocompromised patients with autoimmune diseases.
    • Comprehensive nursing care is essential for optimizing outcomes in patients with complex systemic sclerosis and its sequelae.