Subsepsis allergic Wissler-Franconi

Subsepsis allergic Wissler-Franconi . Etiology, pathogenesis are unclear. The disease is considered a special form of rheumatoid arthritis. Infection, more often sluggish focal, is a provoking factor. At the heart of pathogenesis, perhaps, is an autoimmune pathological process, leading to the defeat of various organs and systems.

Clinical picture. Children are more often ill from 4 to 12 years. The disease begins sharply with a high, sometimes hectic temperature, which lasts for many weeks and months (38.5-39 degrees Celsius), in some cases with a morning maximum and large fluctuations throughout the day. Typical polymorphic rash on the skin (utrmkarnaya, spotty-papouzny, anulyarnaya exudative-hemorrhagic, etc.), localized on the limbs, less often on the face, chest, abdomen. Often marked arthralgia or other joint damage. There may be a paroxysmal pain in the abdomen, an increase in the lymph nodes, spleen, liver. Neurovegetative disorders are often noted: chills, tachycardia, arrhythmia, sweating, mental disorders (feelings of fear, sleep disturbance, euphoria). Typical (in the initial period) hematological changes: leukocytosis (14-20 â,¬ 1000 in 1 μl) with neutrophileosis, shifting the formula to the left, persistent increase in ESR (30-60 mm / h) for 3-6 months.

In the future there is a tendency towards leukopenia, ESR decreases. Hyperproteinemia, hypoalbuminemia, increased gamma globulins, increased levels of immunoglobulins M and G, decreased serum complement.

The diagnosis is based on the history and clinical course.

Differential diagnosis is performed with rheumatism, systemic lupus erythematosus, systemic scleroderma, osteomyelitis, sepsis, typhoid fever.

Treatment. In addition to general measures (hospitalization, bed rest), antibiotics, according to indications, include acetylsalicylic acid (0.06-0.07 g / kg 3-4 times a day after meals), often in combination with brufen [10-15 Mg / (kg-day)] or voltarenom [2-3 mg / (kg-day)]; In severe cases, appoint glucocorticoids (prednisolone) in combination with indomethacin or butadione. To the basic means in the treatment include preparations of 4-aminoquinoline series [delagil-5 mg / (kg-day), plakvenil-8 mg (kg-day)].

The prognosis is serious; Often the disease is transformed into juvenile rheumatoid arthritis.

Prevention: treatment of foci of chronic infection, hyposensitizing therapy.