Case Report
Year: 2022 | Month: July | Volume: 9 | Issue: 7 | Pages: 1-5
DOI: https://doi.org/10.52403/ijrr.20220701
The Challenges of Diagnosis and Management of Geriatrics with Systemic Sclerosis: A Case Report
IGNG Bayu Prawira Putra1, RA Tuty Kuswardhani1
1Department of Internal Medicine, Faculty of Medicine, Universitas Udayana, Sanglah General Hospital, Bali, Indonesia.
Corresponding Author: IGNG Bayu Prawira Putra
ABSTRACT
Scleroderma (systemic sclerosis) is a rheumatic autoimmune disease characterized by skin fibrosis, internal organ damage, and systemic vasculopathy. Scleroderma in elderly patients presents with non-specific symptoms that overlap with another medical condition.
A woman, 63 years old, came with a chief complaint of thickening and darkening of the skin since ten years ago. The patient also complained of shortness of breath and decreased urine in 3 weeks. On physical examination, the patient was having ascites. Multiple diffuse hyperpigmented in the thoracal, abdominal, and extremities areas. Based on the 2013 ACR/EULAR (American College of Rheumatology; European League Against Rheumatism) classification criteria, the patient was diagnosed with scleroderma with systemic sclerosis, overlapping with other medical conditions such as diabetes mellitus, chronic kidney disease stage V, urinary tract infection, and hypoalbuminemia.
Most of the systemic symptoms in systemic sclerosis patients were not specific. The progressive cardiopulmonary disease is critical in systemic sclerosis, especially in geriatrics. Interstitial lung disease can progress to pulmonary hypertension as a late and terminal complication. It is recommended for routine screening for interstitial lung disease.
Keywords: Scleroderma, systemic sclerosis, geriatric.
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