Linfohistiocitosis hemofagocítica en trasplante renal

Palabras clave: Ferritinas, Histoplasmosis, Linfohistiocitosis Hemofagocítica, Trasplante Renal

Resumen

La linfohistiocitosis hemofagocítica (LHH) posterior al trasplante renal hace referencia a un estado hiperinflamatorio grave, asociado a la activación no controlada de los linfocitos T citotóxicos y macrófagos por causa infecciosas y/o secundaria al tratamiento inmunosupresor. Las causas más prevalentes dentro de las infecciones son la histoplasmosis, la tuberculosis y las infecciones por virus herpes. Se caracteriza por fiebre, organomegalias, citopenias, hiperferritinemia, hipertrigliceridemia y/o hipofibrinogenemia; puede acompañarse con hemofagocitosis documentada en la médula ósea, el hígado u otros órganos. Su curso puede ser fulminante con progresión a falla multisistémica y la muerte.

El tratamiento va enfocado a controlar tempranamente la causa desencadenante, reducir la inmunosupresión y controlar la inflamación. En pocos casos es necesario el uso de otros inmunosupresores, quimioterapia o, en situaciones muy seleccionadas, se puede requerir el trasplante de médula ósea.

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Biografía del autor/a

John Fredy Nieto-Ríos, Hospital Pablo Tobon Uribe. Universidad de Antioquia.

Nefrólogo, Departamento de Nefrología y Trasplante renal Hospital Pablo Tobón Uribe, Medellín Colombia.

Carol Lisbeth Morales-Contreras, Universidad de Antioquia.
Docente, Departamento de Medicina Interna, Universidad de Antioquia. Medellín Colombia.
Diana Carolina Chacón-Jaimes, Universidad de Antioquia.
Residentes de Nefrología. Universidad de Antioquia.
Diego Armando Benavides-Henao, Universidad de Antioquia.
Residentes de Nefrología. Universidad de Antioquia.
Diana Carolina Bello-Márquez, Universidad de Antioquia.
Nefróloga Pediatra, Departamento de Nefrología. Urogine. Medellín, Colombia.
Lina Maria Serna-Higuita, Universidad de Tuebingen, Alemania.

Estudiante de Doctorado, Eberhard Karls University, Institute for Clinical Epidemiology und Applied Biometrics, Tuebingen, Germany.

Citas

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Publicado
2019-10-01
Cómo citar
Nieto-Ríos, J. F., Morales-Contreras, C. L., Chacón-Jaimes, D. C., Benavides-Henao, D. A., Bello-Márquez, D. C., & Serna-Higuita, L. M. (2019). Linfohistiocitosis hemofagocítica en trasplante renal. Iatreia, 32(4), 311-320. https://doi.org/10.17533/udea.iatreia.21
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