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PRO736804001074591154
PRAXI911804001074692148201221
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praxi.1537804001075077118158177193
2025;26(4):242-2451750804001074487128172185229272295337358373417457498523562602644
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2421258020012657115172
SDĚLENÍ341200012656130188244301376409
Z772200012659
PRAXE853200012660123195263321
Na34136001063979
co43636001063271
upozornila52336001063873114146184220262279310352
bolest89136001063475106138173205
dolních111236001063879110152169204245
končetin137336001063372113148180214231273
aneb166136001063879111147
„nemoc18233600106266799154194229
noha-střevo-játra“206836001063980121161188218250286318358397427447486514550592616
Na3409200298166292
co6809200298109244
upozornila972920029814028242053066775689595810221148
bolest21689200298144281346471575661
dolních28789200298143279344483547652792
končetin37189200298131264403510633721786925
aneb34011800298127265390533
„nemoc92111800298111249374580717825
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MUDr.3401580013793168245287310
David6721580013777135191221287
Klepárník1,981158001376899157223281323387417479145815900803614931580013729
MUDr.15441580013793168245287310
Mária18761580013793152194223281
Véghová-Velgáňová1,21801580013770123188253316373431467534588619683742806869926984315615900803631901580013729
MUDr.32411580013793168245287310
Lenka35731580013756115180239298
Rašková2,38931580013765124171231293350408430015900803643381580013729
doc.3401730013766129179209
MUDr.5711730013793168245287310
Jana9031730013746104168226
Volejníková,11511730013770129159218249313343405467524582611
Ph.D.1178417300137641281562352612038174008036
1Dětská3401890078333711890013373128165209260313
klinika,708189001335178103163188239293315
Lékařská10471890013352106157211246290341394
fakulta1465189001333285136197222258311
Univerzity17991890013371131156209263298347372408463
Palackého22851890013358110135188236287340401461
a27701890013353
Fakultní28461890013354102153213239274335360
nemocnice32291890013361116208268318378403451505
Olomouc37571890013376102163254314375424
2Dětské3402040078333732040013373128165209260313
oddělení7092040013361123185240266320381406
Nemocnice11382040013373128220280330390415464517
Agel16782040013368128183208
Jeseník,1910204001334196139194255280333358
a.2291204001335376
s.2381204001334366
Třináctiletý,340255001215085109165213259295318342393427478495
v8632550012149
předchorobí941255001215891141200245301357391446504528
zdravý14982550012144101134183230282
chlapec18092550012145101125174231283330
byl21672550012158105130
přijat2326255001215791115139188221
k25762550012147
hospitalizaci26522550012156112152209233267317341364408458504527
pro3208255001215891147
tlakové3383255001213458106154208256306
až3718255001214993
křečové340269001214781131177231278327
bolesti6962690012157113137188227261285
dolních10092690012157112136191215259315
končetin13522690012147101157202251285308363
nereagující17442690012155106139189237294349373396441464
na22362690012156104
běžná23682690012158109152208256
analgetika.26522690012149104152176232283316340386436457
Bolesti31382690012154110134184224258281
následovaly34482690012155103143166217274329340283001214897120167
po5322830012157113
respiračním669283001213382122178202235283328383406489
infektu1183283001212378107157205240295
s15032830012139
kašlem1567283001214796135158209292
a18832830012149
horečkou,19562830012155111144193239285339394415
jiné2395283001212548103153
obtíže25732830012155112145168211261
neměl.28582830012156106190240264285
V31672830012156
laboratorních3247283001212472129185218266299353386441465509564
odběrech3402970012154111167217250299344398
nebyly7562970012155105161207230277
známky1051297001214297144227273323
myositidy,13912970012183128181220242275298353400416
naopak18242970012155103157214262308
překvapilo2149297001215789138185235283339362385440
významné2606297001214898142197244327381431
zvýšení3054297001214393143182232287309
gama-glutamyltransferázy33812970012155103185232264322345399340311001213382165211235268300349404443473523556605648698
(GGT),1063311001212991156206237256
alkalické1344311001214872118167191214258305354
fosfatázy1723311001212984124154203235284327377
(ALP),2126311001212888135188214232
pouze23843110012157113168211261
mírné26703110012184107140195246
zvýšení2941311001214394145184234290313
transamináz,3279311001213466115170209258341364419467511532
konjugovaného340325001214698152174227281334380427480529583636
bilirubinu992325001215678100122153207262284337390
a13983250012147
laktátdehydrogenázy1461325001212370115149196227281330384428481513565620669723769811859
(LDH).2336325001212872136200226243
Po25953250012152104
vyloučení2714325001214896119173226270317371393
infekční3122325001212377104153198240293315
etiologie3453325001214981103156179232287309358
byl3403390012157103128
přeložen486339001215790139163218261310366
do8703390012157112
fakultní1000339001213079125181204237292315
nemocnice,13343390012155106189244290345368413462482
kde18343390012147102153
byla20053390012157103128176
diagnostikována2199339001215680127183239294333367390437490537586641689
ulcerózní2907339001215578123172205259301357380
kolitida33053390012147101125148181204261309
(UC)3632339001212892150179
a3403530012148
primární409353001215790114197245278333356
sklerozující787353001213986111161194248290345369392437460
cholangitida12683530012145100155179227282338362395418474522
(PSC).1811353001212981130188217236
Kuriózním3403670012154107140163218259315338421
vedlejším778367001214897154177227251290313396
nálezem11913670012156103127177220270353
v15623670012147
průběhu1627367001215790145201252307362
vstupní2006367001214888121176232288311
diagnostiky2334367001215780127183238293332366388435485
byla28373670012156103127174
rentgen-kontrastní3029367001213382138170225275330362410464519551583632671704759782
tableta340381001213382139163213247295
KCl6573810012154110132
v8113810012148
zažívacím880381001214393136159207256301324407
traktu,1308381001213366114161197252272
imitující16023810012123106129163217241264309332
cizí1955381001214568111134
těleso.2110381001213382106157196251271
Cílem340395001215779104153236
sdělení593395001213995144167217271294
je904395001212473
upozornit9943950012155110165206260292347370402
na14133950012155102
neobvyklou15323950012155104159215262311358382437491
a20403950012148
často2105395001214492130163216
nenápadnou23383950012155104159206262310365420474528
manifestaci28833950012183130184207235285323356404448471
závažného3371395001214291137184227281331385440
jaterního340409001212472105154187243266323378
onemocnění.7394090012155111161245300346401451507530551
Klíčová340425001246189116160217269321
slova:677425001244371128179232257
bolest9504260012156111135185223257
dolních12244260012156110134188210254309
končetin,1550426001214699154198246279302356376
hepatopatie,19434260012155105161209241294350398430453502522
nespecifické24824260012155105143199249294317346371415461509
střevní3008426001214073105153200256278
záněty3303426001214392146196229278
(IBD),3598426001212850104170195214
primární340440001215790113197245277333356
sklerozující717440001214086111162195249291346370393438460
cholangitida11994400012144100155179227282338361394417474522
(PSC),1742440001212881130187217236
ulcerózní1999440001215578123172205260301357380
kolitida24004400012147101125148181204260308
(UC).2730440001212892150179198
„Leg-Gut-and-Liver340467001244698151211244316375412443497556616649702730783835873
disease“:1234467001245987131184238281335381404
leg1658467001242881141
pain18194670012460113141199
as2039467001245396
an21554670012453112
unusual22874670012458118176220278331359
indicator2666467001242887147175220274310368407
of340481001245892
ulcerative453481001245886131184223276312341394446
colitis9194810012445103131158195224267
and12074810012452111171
primary1398481001246099126212266304359
sclerosing1777481001244489117171210268311339398457
cholangitis22544810012445104162191244303361389426455498
A3404990012161
13-year-old427499001215195126172220267299326382405461
previously914499001215789137184207261315353375422
healthy13624990012155105152174206260305
male16934990012183130153202
was19214990012174121159
admitted21064990012148104186208241275323379
for2511499001213084116
pressure2653499001215688137176214267299348
and30274990012148102158
cramping3211499001214476123205261284338393
pain36304990012157105127181
of340513001215583
the442513001213387137
lower598513001212378149198230
limbs,847513001212445128183222242
unresponsive11085130012155109141190228284339393431453500548
to1675513001213487
common1781513001214497180262316371
analgesics.21715130012148102149172227276315337380420440
The26315130012149105154
episode28045130012150106129167221277326
of3150513001215483
pain32525130012157104126181
followed3452513001212983106128182254303359
a3405270012148
respiratory403527001213281118173195226273304356388436
infection854527001212477105153197231252305359
with1229527001217395126180
cough1424527001214496150204258
and16975270012148101156
fever;1868527001212978124171202222
there2106527001213286135166214
were23355270012173121152200
no25515270012155108
other2674527001215586139188219
concurrent2909527001214496150193246277309357411441
symptoms.3366527001213985167222254306388425445
Laboratory340541001214794149203234281312364395443
tests798541001213381118150189
showed1002541001213992146216264319
no13365410012155108
evidence1459541001215095118172221274317364
of1839541001215481
myositis19355410012183127179216237269290327
but,22775410012156110141161
surprisingly,2453541001213992122178209231268289342396418464478
a29465410012148
significant3009541001213961115168189217242284331384415
elevation3439541001215072120166213243265318372
of340555001215481
gamma-glutamyltransferase4365550012155101182263309339395417469500547628671694725756802855892920968999104610831131
(GGT),1582555001212888150198227244
alkaline1841555001214869114161182204257305
phosphatase21615550012156110163200254308354384431468516
(ALP),2692555001212886131182206223
only29295550012155108130175
mild31195550012182104125179
elevations3313555001215072120166212243264317370407
in3735555001212376
transaminases,340569001213365112166204252334356411458496545584604
conjugated960569001214598153175229284331362410467
bilirubin1443569001215780102124156210266288343
and18025690012148102158
lactate1977569001212370114148196228276
dehydrogenase22695690012157106161205260291345401450505552590639
(LDH).2925569001212873138203229247
After3188569001216289125173205
excluding3409569001215096139161215271293347402
hepatotropic3405830012156105161209241294326358411468491534
infections,901583001212378106155200234256310365403423
he13515830012155105
was14825830012174122160
transferred1668583001213365113167205234283315348396453
to2147583001213387
a22605830012148
tertiary2335583001213381113148170217249298
care2660583001214492124173
hospital,28595830012156110148204227259307329349
where32345830012174129179211260
he35205830012155105
was36515830012174122160
diagnosed340597001215679125180235289327377433
with792597001217496129183
ulcerative994597001215577121169201249280302350398
colitis1411597001214597120142174196234
(UC)1664597001212991148177
and18605970012148103158
primary2037597001215789112194241273322
sclerosing2378597001214084106155187241279301355410
cholangitis2807597001214599153176223278333355387409447
(PSC).3273597001212880128184213230
A3406110012161
peculiar4236110012157108153208232255302335
incidental779611001212479124147203254309342391414
finding1215611001212955110167190245301
during15386110012156111143167222278
the1838611001213388138
initial1998611001212379102135158206229
diagnostic2248611001215780128184239294334367390435
work-up27056110012173127160207236292349
was30756110012174122161
a32586110012148
radiopaque3328611001213281138161216273322378433483
tablet340625001213382139163213247
of608625001215584
potassium7136250012157113146194234273296350433
chloride1168625001214499123178211234291341
in1530625001212479
the1630625001213388139
digestive1790625001215780136186226259282331380
tract,2191625001213366114159194215
mimicking24286250012183106189213257304329384440
a28896250012148
foreign2959625001212984117166190246301
object.32826250012154112135186231267288
The3406390012150106157
aim522639001214871154
of702639001215584
this811639001213388111150
case987639001214493132182
report1195639001213382139195228264
is1485639001212362
to1572639001213387
emphasize16856390012150133190246294333356399449
unusual21596390012155111165204259307330
and25146390012149104160
often2700639001215584120169225
subtle2950639001214095151184208258
manifestation32336390012184132187210239290329363412444467522578
of340653001215584
a4456530012148
severe515653001213990137186219269
liver80565300121244795144177
disease.1003653001215780119169217256307327
Key3406690012461112164
words:5216690012475132170230274300
hepatopathy,8386700012155106162211243297354402435490535551
inflammatory1407670001212378107133181263346394427480513563
bowel19886700012157112185234258
disease2264670001215679118168216255305
(IBD),2586670001212951105172198217
leg2820670001212474130
pain,29686700012157106128183204
primary3190670001215689113196243276326
sclerosing3534670001213984107157190244340684001214062118174
cholangitis5356840012145100155179227282338361395418456
(PSC),1013684001212880129187217235
ulcerative1269684001215579124173206254287310358407
colitis1697684001214599123146179202241
(UC).1959684001212892150179198
Úvod3407170014780142208279
Primární48073400109487697171214242292312
sklerozující81473400109367799144173222259308329349389409
cholangitida1245734001094089138159202251301321351371421464
(PSC)1731734001092572115167193
je1946734001092266
závažné340748001093983124167206255300
progredující661748001095180129179208252303352373393433453
onemocnění1135748001094999144218267308357402451472
žlučovodů1627748001093960108148196238286337385
s3407620010936
nízkou,400762001095172111153202252271
ale695762001094465111
konstantně830762001094392142177208252302331382427
stoupající1282762001093666115165217261282303344364
incidencí1671762001092171112133184230280321341
(u340776001092673
dětí437776001095297127148
cca609776001094181125
17587760010947
:8157760010919
200844776001094792140
000–1994776001094795143192233
:12377760010919
5001266776001094792140
000).1416776001094795143168184
Nastupuje16257760010960104139169219271321342388
typicky2140720001093074125146186227272
ve2430720001094387
2.2534720001094665
dekádě2617720001095095137181231276
života2910720001093959102150179223
a31507200010944
postihuje32117200010952101136166186235284305350
častěji3578720001094184119148192213233
muže.21407340010977128168214232
Zásadní2397734001095297133178231282303
je2725734001092369
asociace2819734001094581132174196240281327
s31717340010936
nespecifickými3232734001095298135187235277298325349391434480558579
střevními214074800109366796141184235256331352
záněty2517748001093984134179210255
(IBD):279674800109264696156180197
2–8%3018748001094690138220
pacientů3263748001095296136157203253282332
s36197480010936
IBD3680748001092171131
trpí2140762001093059110131
i22957620010921
PSC2340762001094891143
a25077620010944
naopak,2574762001095193143194237279300
ulcerózní2897762001095071111155184233270320340
kolitida3261762001094290112132161182232275
(UC)3560762001092582134161
je3744762001092267
přítomna2140776001095180101130178253302345
u25047760010950
75–90%2573776001094689135180227308
pacientů2900776001095195135155199249277326
s32467760010935
PSC.3301776001094891143163
Etiologie348377600109447393142164213263283328
DECLARATIONS:4068257008648871301662142563043393604124625014570257008514
Declaration406827100874987120141179206244271291333375
of445727100874066
originality:45372710087406888130150192230251271298337356
The406828200853473109
manuscript418828200855891130168195227249266306329
is452828200851744
original45832820085386178117133172205222
and481628200853472112
has49392820085387299
not50502820085387699
been516128200853975110149
published532228200853977117134150177216251291
or406829300853862
submitted414529300852867108167184208234269310
elsewhere.44702930085355381117169209245269305320
Ethical406830700873764107127160198218
principles43003070087427090132165185228249287319
compliance:463330700873173134177197218256298330368387
The406831800853678116
authors420531800853475100142183208238
attest44643180085356087124153179
that466431800852465101126
their481131800852465103121146
study49783180085295595138173
was517331800855389118
approved531231800853577120145186221258301
by406832900854073
the41583290085236399
local42743290085175689124141
Ethical44323290085345898115147182199
Committee464832900854179139198215239265300337
and500232900853373113
is513232900851745
in519432900851656
compliance526732900853169129169187204239278311346
with40683400085537298140
human423634000854081143180221
studies44863400085285596139157195226
and474034000853577119
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welfare512834000855391110133170196234
regulations53903400085236110414516420140683510085234080120148
of423535100853960
the43153510085236399
authors’44343510085347397136176200229244
institutions46983510085165684109126150189213231270310338
as505635100853462
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of528836200853961
Helsinki537036200854684102131149189224243
on406837300854082
Ethical418537300853561104123157195214
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for47803730085216389
Medical490437300855897141160194232251
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ing551137300851759102
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Subjects430738400853474114132168201227256
adopted458338400853474114155179215256
by485838400854074
the49523840085236399
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WMA5198384008559116160
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Assembly406839500854475105143204247266302
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Finland,47613950085355394113149190232249
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as508840600853362
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the53184060085236298
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Recommendations406841700853977112153216278317359402439465483525568598
for46974170085226389
the481841700852466104
Conduct,495441700854283125168210245272290
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2018,503743900853673107140156
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interest44134640087196288126154192224251
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None.406847500854686126162177
Funding/Support:406848900873777119162183225267291329371414457499526554574
Tato40685000085366792132
práce422550000854166102136172
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