A 31 y.o. patient has been suffering from systemic scleroderma for 14 years. She has been treated in hospital many times. She complains of occasional dull pain in the heart region, palpitation, dyspnea, headache, eye-lid edemata, weight loss and deformation of extremities joints. What organ affection worsens the disease prognosis?

Answer options

1. Lungs
2. Gastrointestinal tract
3. Skin and joints
4. Kidneys
5. Heart

Explanation

A 31 y.o. patient has been suffering from systemic scleroderma for 14 years. She has been treated in hospital many times. She complains of occasional dull pain in the heart region, palpitation, dyspnea, headache, eye-lid edemata, weight loss and deformation of extremities joints. What organ affection worsens the disease prognosis? The most affected organ is the kidney because the patient has complained of eyelid edema. "scleroderma renal crisis" has been used to characterize the renal involvement in scleroderma, in which malignant hypertension occurs over a day to a week and is associated with acute renal failure ( rapid rise in creatinine and protein). The best drug to treat in this case is ACE inhibitors. In this case, the patient develops eye lid edema which is the result of protein loss because of renal failure.