Pediatr. pro Praxi, 2002; 4: 175-179 [Interní Med. 2002; 4(1): 24-28]

Nejčastější metabolicky podmíněná onemocnění jater u nemocného v adolescentním věku

prof. MUDr. Marie Brodanová DrSc
I. interní klinika 1. LF UK a VFN Praha

Keywords: Gilbert´s syndrome, benign hyperbilirubinemia, unconjugatedbilirubinemia, Wilson´s disease, ceruloplasmin, disorders of copper metabolism.

Published: December 31, 2002  Show citation

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Brodanová M. Nejčastější metabolicky podmíněná onemocnění jater u nemocného v adolescentním věku. Pediatr. praxi. 2002;3(4):175-179.

Práce shrnuje nejdůležitější poznatky o nejčastěji se vyskytujících metabolicky podmíněných chorobách, které se obvykle manifestují v adolescentním věku - benigní hyperbilirubinémii a Wilsonově chorobě. Hyperbilirubinémie je častým nálezem, zcela nezávažným. Úkolem lékaře je dobře ji diagnostikovat a vysvětlit nemocnému benignost onemocnění, zbavit jej obav a neordinovat žádná terapeutická či režimová opatření. Naopak při podezření na Wilsonovu chorobu je nutno postupovat zcela odpovědně od prvého okamžiku, protože dnes dostupná diagnostika dovoluje zachytit onemocnění již v klinicky latentním stadiu a včasnou léčbou zabránit rozvoji onemocnění. Léčba je natolik úspěšná, že nemocný může žít zcela normálním životem. Terapie musí být celoživotní. Ošetřující lékař proto musí pravidelně nemocného sledovat, případně spolupracovat s příslušným centrem. Neopomene vyšetřit všechny sourozence.

The most common metabolic disorders involving liver among adolescent patients

The article summarizes the most important information of the most frequent metabolic disorders to be found in adolescent age - benign hyperbilirubinemia and Wilson´s disease. Hyperbilirubinemia occurs quite often, it is entirely benign. The task of a physician is to diagnose it correctly and explain harmless features of this disorder to a patient, to relieve him from anxiety and not to take any therapeutic or dietary precautions. On the contrary, when Wilson´s disease is suspected, it is absolutely necessary to proceed with great responsibility from the very beginning, because present available diagnostic methods allow us to detect disease in clinically latent stage and thus to prevent it from fatal consequences by early therapy. The treatment is successful so far, that a patient can live normal life. Once initiated, therapy must be continued forever. A patient has to be followed up on regular basis by an attending physician or in cooperation with specialized center. All siblings have to be examined as well.

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