The specific features of syndrome of undifferentiated connective tissue dysplasia and collagen exchange indices in case of its combination with the gastroesophageal reflux disease
Journal Title: Сучасна гастроентерологія - Year 2019, Vol 0, Issue 3
Abstract
Objective — to determine the prevalence of phenotypic and visceral markers of syndrome of undifferentiated connective tissue dysplasia (UCTD) and nature of connective tissue changes in patients with gastroesophageal reflux disease (GERD). Materials and methods. The study involved 120 patients: 45 (Group I) patients with GERD, and 75 patients (Group II) with GERD against the background of UCTD. The control group consisted of 12 practically healthy persons, without UCTD signs. The mean age of the patients was 42.0 ± 6.5 years. Evaluation of the UCTD signs was performed according to the criteria recommended by M. Moska et al., A. Doria et al., T. I. Kadurina, L. M. Abbakumova in the modification of T. Milkovskaya-Dimitrova, and the degree of their expression was assessed with the scale of T. Y. Smolnova. Concentration of oxyproline (OP) in blood serum and daily portion of urine was determined by photocolorimetric method; serum levels of Matrix metalloproteinase-9 were defined with immunoenzyme technique. Results. It has been demonstrated that in comparison with the patients of group I, the following UCTD indices were higher in group II: Raynaud’s phenomenon in 2.1 times, arthralgia in 6.4 times, dysphagia in 1.9 times, periodic skin rashes in 3.2 times, ulcers of oral mucous in 3.7 times. The proximal muscular weakness developed more frequent in patients of the Group I. At the same time, in 88.0 % of patients of the Group II abnormalities in the development of internal organs have been revealed, while in the patients of Group I only in 6.6 %. Nephroptosis and kidney dystopia were found in 46.6 % of patients with comorbidity and in 15.5 % of patients with isolated GERD; gall bladder abnormalities were more often (86.6 %) in Group II, than in Group I (11.1 %). The OР levels in blood serum and daily portion of urine in patients of Group I did not differ from those in healthy subjects, but were lower in 1.7 times compared to Group II. The urine OР levels in patients of Group II were higher in 2.9 times vs control group, and in 89 times higher (p < 0.05) than in Group I. The Matrix metalloproteinase-9 level in patients of Group I was in 1.9 times higher, and in Group ІІ in 2.4 times higher compared to the control group (p < 0.05). Conclusions. In adults with GERD against UCTD background, arthralgia, Raynaud’s phenomenon, reduced body mass, bone, articular and skin phenotypic signs prevailed, that correlated with GERD frequency and duration. The above changes should be taken into consideration during the choice of the treatment strategy for this group of patients.
Authors and Affiliations
V. G. Mishchuk, I. B. Romash
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