Microangiopatía trombótica en Lupus Eritematoso Sistémico: a propósito de tres casos

Carolina Muñoz-Grajales, Nicolás Coronel-Restrepo, Luis Fernando Pinto-Peñaranda, Carlos Jaime Velásquez-Franco, Javier Dario Márquez-Hernández

Resumen


Se describen tres casos de pacientes con lupus y microangiopatía. Los casos descritos representan las principales condiciones asociadas a lupus que pueden generar anemia microangiopática, como son: anemia hemolítica microangiopática, síndrome antifosfolípido con microangiopatía localizada y síndrome antifosfolípido catastrófico. La alta mortalidad que conlleva la anemia microangiopática, sin el tratamiento oportuno, hace necesario motivar a los clínicos a conocer ampliamente la enfermedad para poder reconocerla prontamente.

Palabras clave


Anemia Microangiopática; Lupus Eritematoso Sistémico; Microangiopatía Trombótica

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Referencias


(1.) Shenkman B, Einav Y. Thrombotic thrombocytopenic purpura and other thrombotic microangiopathic hemolytic anemias: diagnosis and classification. Autoimmun Rev. 2014 Apr-May;13(4-5):584-6. DOI 10.1016/j.autrev.2014.01.004.

(2.) Török TJ, Holman RC, Chorba TL. Increasing mortality from thrombotic thrombocytopenic purpura in the United States--analysis of national mortality data, 1968-1991. Am J Hematol. 1995 Oct;50(2):84-90.

(3.) Lansigan F, Isufi I, Tagoe CE. Microangiopathic haemolytic anaemia resembling thrombotic thrombocytopenic purpura in systemic lupus erythematosus: the role of ADAMTS13. Rheumatology (Oxford). 2011 May;50(5):824-9. DOI 10.1093/rheumatology/keq395.

(4.) George JN, Al-Nouri ZL. Diagnostic and therapeutic challenges in the thrombotic thrombocytopenic purpura and hemolytic uremic syndromes. Hematology Am Soc Hematol Educ Program. 2012;2012:604-9. DOI 10.1182/asheducation-2012.1.604.

(5.) Crawley JT, Scully MA. Thrombotic thrombocytopenic purpura: basic pathophysiology and therapeutic strategies. Hematology Am Soc Hematol Educ Program. 2013;2013:292-9. DOI 10.1182/asheducation-2013.1.292.

(6.) Baron JM, Baron BW. Thrombotic thrombocytopenic purpura and its look-alikes. Clin Adv Hematol Oncol. 2005 Nov;3(11):868-74.

(7.) Sadler JE, Moake JL, Miyata T, George JN. Recent advances in thrombotic thrombocytopenic purpura. Hematology Am Soc Hematol Educ Program. 2004:407-23.

(8.) Terrell DR, Williams LA, Vesely SK, Lämmle B, Hovinga JA, George JN. The incidence of thrombotic thrombocytopenic purpura-hemolytic uremic syndrome: all patients, idiopathic patients, and patients with severe ADAMTS-13 deficiency. J Thromb Haemost. 2005 Jul;3(7):1432-6.

(9.) Dold S, Singh R, Sarwar H, Menon Y, Candia L, Espinoza LR. Frequency of microangiopathic hemolytic anemia in patients with systemic lupus erythematosus exacerbation: Distinction from thrombotic thrombocytopenic purpura, prognosis, and outcome. Arthritis Rheum. 2005 Dec;53(6):982-5.

(10.) Letchumanan P, Ng HJ, Lee LH, Thumboo J. A comparison of thrombotic thrombocytopenic purpura in an inception cohort of patients with and without systemic lupus erythematosus. Rheumatology (Oxford). 2009 Apr;48(4):399-403. DOI 10.1093/rheumatology/ken510.

(11.) Jiang H, An X, Li Y, Sun Y, Shen G, Tu Y, et al. Clinical features and prognostic factors of thrombotic thrombocytopenic purpura associated with systemic lupus erythematosus: a literature review of 105 cases from 1999 to 2011. Clin Rheumatol. 2014 Mar;33(3):419-27. DOI 10.1007/s10067-013-2312-5.

(12.) Ruiz-Irastorza G, Crowther M, Branch W, Khamashta MA. Antiphospholipid syndrome. Lancet. 2010 Oct;376(9751):1498-509. DOI 10.1016/S0140-6736(10)60709-X.

(13.) Miyakis S, Lockshin MD, Atsumi T, Branch DW, Brey RL, Cervera R, et al. International consensus statement on an update of the classification criteria for definite antiphospholipid syndrome (APS). J Thromb Haemost. 2006 Feb;4(2):295-306.

(14.) Lim W. Antiphospholipid syndrome. Hematology Am Soc Hemato Educ Program. 2013;2013:675-80. DOI 10.1182/asheducation-2013.1.675.

(15.) Pons-Estel GJ, Cervera R. Renal involvement in antiphospholipid syndrome. Curr Rheumatol Rep. 2014 Feb;16(2):397. DOI 10.1007/s11926-013-0397-0.

(16.) Nochy D, Daugas E, Droz D, Beaufils H, Grünfeld JP, Piette JC, et al. The intrarenal vascular lesions associated with primary antiphospholipid syndrome. J Am Soc Nephrol. 1999 Mar;10(3):507-18.

(17.) Daugas E, Nochy D, Huong DL, Duhaut P, Beaufils H, Caudwell V, et al. Antiphospholipid syndrome nephropathy in systemic lupus erythematosus. J Am Soc Nephrol. 2002 Jan;13(1):42-52.




DOI: https://doi.org/10.17533/udea.iatreia.v31n2a08 Resumen : 712 PDF : 481

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