5/1(火)
◆今日の気持ち
(膠原病科 2ヶ月目)
・やたら忙しいのはなぜ??
●今の目標
・きっちり仕事する
●今日の新患・診断
・RA、DM、IP
●今日の病院滞在時間
8時〜27時半
●今日行ったこと・見たこと・知ったこと
・MTX
葉酸阻害で免疫抑制
→葉酸(フォリアミン)で副作用(肝障害など)を抑えることができる。もちろん、作用も。
・肩の骨
骨自体はOKでも、痛くて動けないと肩の骨粗鬆症が進むので、X線でよく見える
・抗SS-A症候群(シェーグレンとかSLEとか)
ダウン症と同じくらい(0.1%)いる。母体の抗体が胎児を攻撃し、新生児ループスに
・SScにリハビリ
必要。拘縮する
・レイノーの治療に
寒冷・喫煙を避ける
・気管支
壁肥厚・内壁拡張・マイクロハニカム
・DMにIVIG
第二選択。100万円くらいかかる…
・シェーグレン
鬱傾向の患者が多い。蛋白漏出症候群を合併することも
・amyopatic DM
IPになると、そうでないものより予後悪い
・DMでも心筋病変あり
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