Colangitis esclerosante primaria. Una revisión narrativa

Palabras clave: Colangitis Esclerosante, Colangiocarcinoma, Colestasis, Colitis Ulcerosa, Neoplasias Colorrectales, Trasplante de Hígado

Resumen

La colangitis esclerosante primaria (CEP) es una patología hepática crónica y rara que se caracteriza
por la inflamación y fibrosis de los conductos biliares, cuya evolución puede llevar a la cirrosis, hipertensión portal y enfermedad hepática en etapa terminal. Su etiología es desconocida, pero se ha relacionado con factores genéticos y autoinflamatorios. Además, tiene una relación muy estrecha con la enfermedad inflamatoria intestinal (EII). Su presentación clínica es muy inespecífica, sus principales síntomas son el prurito y la fatiga.

La prueba estándar para su diagnóstico es la colangiopancreatografía por resonancia magnética (CPRM), donde se observa un aspecto anular ocasionado por estenosis multifocales cortas con segmentos alternos normales o dilatados. Actualmente, no existe ningún tratamiento farmacológico que logre prolongar la supervivencia sin un trasplante de hígado en la CEP. Sólo se puede hacer tratamiento sintomático, especialmente del prurito.

El único manejo curativo con el que se cuenta hoy en día es el trasplante hepático, aunque existe un riesgo de recurrencia de la enfermedad. Es muy importante la vigilancia de los trastornos inflamatorios intestinales, la malignidad y la enfermedad metabólica ósea en estos pacientes. Se ha visto que algunos factores, como el diagnóstico temprano, son de buen pronóstico para la enfermedad.

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Biografía del autor/a

Cristian Camilo Villa-Gómez, Universidad de Antioquia

Estudiante de Medicina, Grupo de Gastrohepatología.

Daniel Stiven Velilla-Aguirre, Universidad de Antioquia

Estudiante de Medicina, Grupo de Gastrohepatología.

Laura Camila Lopera-Restrepo, Universidad de Antioquia

Estudiante de Medicina, Joven Investigadora, Grupo de Gastrohepatología.

 

Sergio Iván Hoyos-Duque, Universidad de Antioquia

Cirujano Hepatobiliar y de Trasplante Hepático, Profesor Titular, Facultad de Medicina, Grupo de Gastrohepatología.

Citas

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Publicado
2020-04-07
Cómo citar
Villa-Gómez, C. C., Velilla-Aguirre, D. S., Lopera-Restrepo, L. C., & Hoyos-Duque, S. I. (2020). Colangitis esclerosante primaria. Una revisión narrativa. Iatreia, 33(3), 251-261. https://doi.org/10.17533/udea.iatreia.57
Sección
Artículos de revisión