This document discusses a case of a 44-year-old female patient with scleroderma who presented with swelling of the hands and feet for one month as well as a dry cough and exertional dyspnea for the past 3 weeks. She has a history of scleroderma for 13 years and hypertension. On examination, she has thickening of the skin on her extremities and pulmonary fibrosis. The document then provides information about scleroderma classifications, pulmonary and renal involvement in scleroderma, and her treatment plan.

1. Pulmonary & renal involvement in scleroderma Dr. Rauf R. Merza ( ASS.PROFESSOR ) Prepared by : Dr. Yahya A. Mohammad

2. A 44 years old female from Kalar presented with swelling of both hands & feet of one month duration .

7. fever with rigor & sweating associated with exertional dyspnea .

8. Systemic review : G.I.T. : dysphagia ( difficulty in swallowing solid food eased by drinking water ) , with

9. Inability to open her mouth widely , heartburn , wt. loss , & constipation .

10. C.V.S. : normal . Resp.S. : dry cough , exertional dyspnea . G.U.T. : bilateral loin pain , dysuria , &

11. frequency . C.N.S. : normal . M.S.K. : generalized bodyache & fatigue .

17. Gyneocological Hx. : G6 P6 A0 Family Hx. : -ve Social Hx. : not smoker or drinker .

24. end inspiratory crackles . Abdomen : soft .no organomegaly .

25. Skin : Thickining of skin of hands , forearms , arms , neck , chest , & lower limbs .

27. over the palmar surface of hands & flexion contractures of fingers specially little finger .

34. Investigations

43. Pulmonary Function Test

44. restrictive lung dis. (pulm. fibrosis )

45. CT scan of chest

54. Scleroderma Classification : 1. Diffuse cutaneous SSc. 2. Limitted cut. SSc.

55. 3. Overlap syndrome . 4. Undefined connective tissue dis. 5. Localized scleroderma .

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