M.R. Aleksandrova - Ph.D. (Med.), Associate Professor, Department of Hospital Therapy with the Courses of Endocrinology, Hematology and Clinical Laboratory Diagnostics, Medical Institute, Peoples′ Friendship University of Russia E-mail: 9166858759@bk.ru L.V. Bychkova - Ph.D. (Med.), Associate Professor, Department of Hospital Therapy with the Courses of Endocrinology, Hematology and Clinical Laboratory Diagnostics, Medical Institute, Peoples′ Friendship University of Russia E-mail: lvb57@bk.ru N.I. Stuklov - Dr.Sc. (Med.), Professor, Department of Hospital Therapy with the Courses of Endocrinology, Hematology and Clinical Laboratory Diagnostics, Medical Institute, Peoples′ Friendship University of Russia E-mail: stuklovn@gmail.com A.H. Azaraksha - Post-graduate Student, Department of Hospital Therapy with the Courses of Endocrinology, Hematology and Clinical Laboratory Diagnostics, Medical Institute, Peoples′ Friendship University of Russia E-mail: hasib2011@yahoo.com G.G. Ivanov - Dr.Sc. (Med.), Professor, Department of Hospital Therapy with the Courses of Endocrinology, Hematology and Clinical Laboratory Diagnostics, Medical Institute, Peoples′ Friendship University of Russia E-mail: ivgen2004@mail.ru

In recent yearsgreat successes in the treatment of Hodgkin\'s lymphoma were achieved due to using modern schemes, in-cluding radiotherapy and polychemotherapy. Modern programs of treatment allows to reach not only the long-term remission of the disease, but also the actual cure of patients with this pathology. Survival and lifetime of patients with this pathology increases, and it is predominantlypeople of young age. Patients, after receiving specialized antitumor treatment and who have achieved a complete remission of disease, are re-moved from the oncological registration , are not on the dispensary observation, that leads to late diagnostic of complica-tions associated with the effects of radiation and chemotherapy. Currently, therapists , cardiologists and endocrinologists have to face with late complications of specialized antitumor treatment. The consequence of radiotherapy, mediastinal irradiation is an early development and progression of atherosclerosis, val-vular lesion, diseases of coronary arteries and electric instability of myocardium. This article deals with the clinical observation of the young woman with the cardiovascular disease, developed in the distant period after chemoradiotherapy Hodgkin\'s lymphoma. This example shows cardiovascular complications and diagnostic difficulties, faced by physicians in daily practice. The young woman at the age of 19 years was diagnosed Hodgkin\'s lymphoma, nodular sclerosis, stage IIA,which were car-ried out the 4 courses of chemotherapy and one course of radiation therapy. Treatment was finished in February 2003, after which achieved complete remission of the disease. 3 years later, after the course of chemoradiotherapy patient was treated about autoimmune thyroiditis. 12 years later, at age of 31, after a specialized antitumor treatment, suddenly appeared clinical symptoms of unstable progressive angina pectoris with which she was hospitalized in the Cardiac Intensive Care Unit of Clinical Hospital of the city Moscow. As a result of examinations of the patient, the differential diagnosis conducted between the acute myocardial infarction without ST segment elevation, complication with acute left ventricular failure, infective endocarditis and pulmonary thromboembolism. After antibiotic therapy, the patient was discharged from the hospital with positive dynamics. A week later, the patient complained substernal chest pain, and she was hospitalized with a diagnosis of unstable progressing angina pectoris.After performing coronary angiography the patient was operated mammary artery- coronary shunting of the anterior interventri-cular branch of the left coronary artery, and prosthesis of mitral valve. In this clinical example demonstration of the development of cardiovascular pathology, pathology of the endocrine system have developed in the late periods after specialized antitumor treatment of Hodgkin\'s lymphoma. Irradiation of the mediastinum at Hodgkin\'s lymphoma with the defeat of intrathoracic lymph nodes is a factor which can provoke the development of cardiac pathology. Patientswhohave been conducted with specializedantitumortherapyandachieved a completeremissionofthediseaseneedto-conductadditionalexaminationtoruleoutcardiovascularpathology, pulmonarycomplications, pathologyoftheendocrinesystem. Inthefuturerecommendationsnotonlyfordiagnostic, butalsomanagementofsuchpatientsneedsto develop.

 

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