Incomplete resolution and followed by bronchiectasis later on. Delayed resolution.
Pleural Effusion,Empyema.
Lung Abscess,ARDS and respiratory failure.
A)Systemic sclerosis without Scleroderma:- i.e internal organ involvement without cutaneous scleroderma. B)Overlap syndrome:- scleroderma associated with other autoimmune disease. C)localized scleroderma:- scleroderma without internal organ involvement. Charachterized by Morphoea which are local patches of scleroderma. D)Limited scleroderma(CREST Syndrome):- There is minimal visceral involvement, positive anticentromere antibodies and good prognosis. Skin hardening is limited to face,feet and fingers. (Calcinosis,Raynaud's phenomenon,Esophageal dysfunction,Sclerodactly,Telangectasia.) E)Diffuse scleroderma:- Diffuse thickening of trunk,proximal and distal limbs with internal organ development and damage so it is life threatening.
Functional disability at the 1st year after start of disease. Radiographic evidence of erosion. Extra-articular manifestations. Subcutanous nodules. High positive Rheumatoid factor.
Shock managment. Nothing by mouth (put pancreas to rest). Aspiration of gastric contents and Analgesics for pain. Iv fluids and Calcuim. Lavage of peritoneum in severe cases. Somatostatin:- decrease pancreatic secretions.
Thyroxin therapy lead to thyrotoxicosis. Vit D lead to hypercalcaemia.
Amiodarone lead to thyroid dysfunction. ACEIs lead to hypoaldosteronism. Sympathomimetics lead to picture like thyrotoxicosis. Steroid therapy lead to DM and cushing syndrome.
Metoclopramide lead to hyperprolactinaemia. Iodide lead to hyperthyrodism. Insulin and oral hypoglycemic lead to hypoglycemia. Lithium lead to hypothyrodism. Ketoconazole lead to hypoadrenalism.