Enfermedad pulmonar intersticial en pacientes con esclerosis sistémica. Revisión narrativa de la literatura

Autores/as

  • María Fernanda Álvarez-Barreneche Clínica CardioVID. Clínica Universitaria Bolivariana.
  • Carlos Jaime Velásquez-Franco Universidad Pontificia Bolivariana. http://orcid.org/0000-0002-6498-0496
  • Miguel Antonio Mesa-Navas Universidad Pontificia Bolivariana.

DOI:

https://doi.org/10.17533/udea.iatreia.v30n3a03

Palabras clave:

Azatioprina, Ciclofosfamida, Enfermedad pulmonar intersticial, Esclerosis sistémica, Micofenolato Mofetil, Rituximab, Tomografía, Trasplante de médula ósea

Resumen


Introducción: la esclerosis sistémica es una enfermedad autoinmune crónica, caracterizada por la tríada de vasculopatía de pequeños vasos, activación del sistema inmune y aumento de los depósitos de matriz extracelular tanto en la piel como en los órganos internos. En los últimos años, el compromiso pulmonar ha cobrado gran importancia, pasando a ser la primera causa de muerte, dada la disminución de la mortalidad por crisis renales con el advenimiento de los inhibidores de la enzima convertidora de angiotensina. La afección pulmonar puede ocurrir como hipertensión o enfermedad intersticial difusa; esta última es más común en pacientes con la variedad generalizada, en los primeros tres años de la enfermedad. Tiene mal pronóstico si no se inicia el tratamiento, cuya meta es detener el deterioro de la función pulmonar. Entre los tratamientos disponibles, la ciclofosfamida cuenta con la mejor evidencia, pero se están estudiando, con resultados preliminares satisfactorios, otros tratamientos como micofenolato mofetil, rituximab, trasplante autólogo de células hematopoyéticas y trasplante de pulmón.

Objetivo: describir, de acuerdo con lo reportado en la literatura, la epidemiología, la fisiopatología, los métodos diagnósticos y el tratamiento de la enfermedad pulmonar intersticial en pacientes con esclerosis sistémica.

Métodos: revisión estructurada, no sistemática de la literatura, enfocada en los aspectos de interés, mencionados y que incluyó 52 artículos. 

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Biografía del autor/a

María Fernanda Álvarez-Barreneche, Clínica CardioVID. Clínica Universitaria Bolivariana.

Medicina Interna, Clínica CardioVID y Clínica Universitaria Bolivariana. Medellín, Colombia

Carlos Jaime Velásquez-Franco, Universidad Pontificia Bolivariana.

Profesor de Medicina Interna, Escuela de Ciencias de la Salud. Reumatólogo. 

Miguel Antonio Mesa-Navas, Universidad Pontificia Bolivariana.

Profesor de Medicina Interna. Escuela de Ciencias de la Salud. Reumatólogo en Clínica Universitaria Bolivariana.

Citas

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2017-07-04

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1.
Álvarez-Barreneche MF, Velásquez-Franco CJ, Mesa-Navas MA. Enfermedad pulmonar intersticial en pacientes con esclerosis sistémica. Revisión narrativa de la literatura. Iatreia [Internet]. 4 de julio de 2017 [citado 5 de diciembre de 2021];30(3):276-8. Disponible en: https://revistas.udea.edu.co/index.php/iatreia/article/view/325139

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