medigraphic.com
ISSN 1817-5996 (Digital)

2020, Número 3

<< Anterior Siguiente >>

Rev Cub de Reu 2020; 22 (3)


Neumonía intersticial con características autoinmunes: reporte de caso

Usma A, Prieto V, Zambrano D, Cifuentes SA, Marín GC, Giraldo MÁM, Saldarriaga RLM

Idioma: Español
Referencias bibliográficas: 24
Paginas: 1-13
Archivo PDF: 462.26 Kb.


RESUMEN

La neumonía intersticial con características autoinmunes por sus siglas en inglés, es una entidad en la que existe un compromiso pulmonar intersticial y hallazgos clínicos y paraclínicos que sugieren una enfermedad del tejido conectivo, aunque no cumplen criterios diagnósticos para ninguna de estas. Con fines de investigación, en el 2015 se describieron criterios para esta entidad, en los que se incluyeron características de los dominios clínicos, serológicos y morfológicos, con diversos patrones de compromiso pulmonar. En la actualidad, hay un aumento en el interés de esta entidad, pues algunos autores sugieren que se pueda tratar de una enfermedad autoinmune per se, cuyo órgano blanco principal sería el pulmón. Dado su reciente reconocimiento, son pocos los casos descritos en la literatura. Con el propósito de contribuir a la mejor identificación de esa entidad, presentamos el caso de una paciente de 68 años con afectación pulmonar en quien después de descartar otras causas se llegó al diagnóstico de neumonía intersticial con características autoinmunes al cumplir los criterios de cada dominio requerido. Se inició tratamiento con micofenolato mofetilo a dosis de 2,5 mg/día. En su evolución clínica, la paciente presentó mejoría y fue dada de alta con tratamiento ambulatorio.


REFERENCIAS (EN ESTE ARTÍCULO)

  1. Fischer A, Antoniou KM, Brown KK, Cadranel J, Corte TJ, du Bois RM, et al. An official European Respiratory Society/American Thoracic Society research statement: interstitial pneumonia with autoimmune features. Eur Respir J. 2015 [Acceso 24/04/2020];46(4):976-87. Disponible en: Disponible en: https://www.thoracic.org/statements/resources/interstitial-lungdisease/interstitial-pna-autoimmune.pdf

  2. Mango R, Makol A, Crowson CS, Ryu JH, Matteson EL. Epidemiology of Interstitial Pneumonia with Autoimmune Features. [abstract]. Arthritis Rheumatol. 2017 [Acceso 24/04/2020];69(suppl 10). Available from: Available from: https://acrabstract s.org/ abstract/epidemiology-of-interstitial-pneumonia-with-autoimmune-features/

  3. Hervier B, Wallaert B, Hachulla E, Adoue D, Lauque D, Audrain M, et al. Clinical manifestations of anti-synthetase syndrome positive for anti-alanyl-tRNA synthetase (anti-PL12) antibodies: a retrospective study of 17 cases. Rheumatology (Oxford). 2010[Acceso 24/04/2020];49(5):972-6. Disponible en: Disponible en: https://academic.oup.com/rheumatology/article/49/5/972/1786211

  4. Denton CP, Khanna D. Systemic sclerosis. Lancet. 2017;390(10103):1685-99. Disponible en: https://doi.org/10.1016/S0140-6736(17)30933-9, https://www.thelancet.com/pdfs/journals/lancet/PIIS0140-6736(17)30933-9.pdf

  5. Robinson AB, Reed AM. Clinical features, pathogenesis and treatment of juvenile and adult dermatomyositis. Nat Rev Rheumatol. 2011;7(11):664-75. Disponible en: https://doi.org/10.1038/nrrheum.2011.139, https://www.nature.com/articles/nrrheum.2011.139

  6. Chan EK, Damoiseaux J, Carballo OG, Conrad K, de Melo Cruvinel W, Francescantonio PL, et al. Report of the first international consensus on standardized nomenclature of antinuclear antibody HEp-2 cell patterns 2014-2015. Front Immunol. 2015;6:412. Disponible en: https://doi.org/10.3389/fimmu.2015.00412, https://www.frontiersin.org/articles/10.3389/fimmu.2015.00412/full

  7. Didier K, Bolko L, Giusti D, Toquet S, Robbins A, Antonicelli F, et al. Autoantibodies associated with connective tissue diseases: what meaning for clinicians? Front Immunol. 2018;9:541. Disponible en: https://doi.org/10.3389/fimmu.2018.00541, https://www.frontiersin.org/articles/10.3389/fimmu.2018.00541/full

  8. Gutsche M, Rosen GD, Swigris JJ. Connective tissue disease-associated interstitial lung disease: a review. Curr Respir Care Rep. 2012;1:224-32. Disponible en: https://doi.org/10.1007/s13665012-0028-7. https://pubmed.ncbi.nlm.nih.gov/23125954/

  9. Kim EA, Lee KS, Johkoh T, Kim TS, Suh GY, Kwon OJ, et al. Interstitial lung diseases associated with collagen vascular diseases: radiologic and histopathologic findings. Radiographics. 2002 [Acceso 24/04/2020];22 Spec No:S151-65. Disponible en: Disponible en: https://www.ncbi.nlm.nih.gov/books/NBK559094/

  10. Kelly BT, Moua T. Overlap of interstitial pneumonia with autoimmune features with undifferentiated connective tissue disease and contribution of UIP to mortality. Respirology. 2018;23(6):600-5. Disponible en: https://doi.org/10.1111/resp.13254, https://pubmed.ncbi.nlm.nih.gov/29320807/

  11. Oldham JM, Adegunsoye A, Valenzi E, Lee C, Witt L, Chen L, et al. Characterisation of patients with interstitial pneumonia with autoimmune features. Eur Respir J. Jun 2016;47(6):1767-75. Disponible en: https://doi.org/10.1183/13993003.01565-2015, https://erj.ersjournals.com/content/47/6/1767.long

  12. Strek ME, Oldham JM, Adegunsoye A, Vij R. A call for uniformity in implementing the IPAF (interstitial pneumonia with autoimmune features) criteria. Eur Respir J. 2016;48(6):1813-4. Disponible en: https://doi.org/10.1183/13993003.01841-2016, https://erj.ersjournals.com/content/48/6/1813.long

  13. Bahmer T, Romagnoli M, Girelli F, Claussen M, Rabe K. The use of auto-antibody testing in the evaluation of interstitial lung disease (ILD) -A practical approach for the pulmonologist. Respir Med. 2016;113:80-92. Disponible en: https://doi.org/10.1016/j.rmed.2016.01.019. https://pubmed.ncbi.nlm.nih.gov/26921132/

  14. van den Hoogen F, Khanna D, Fransen J, Johnson SR, Baron M, Tyndall A, et al. Classification criteria for systemic sclerosis: An ACR-EULAR collaborative initiative. Arthritis Rheum. 2013;65(11):2737-47. Disponible en: https://doi.org/10.1136/annrheumdis-2013204424, https://www.ncbi.nlm.nih.gov/pmc/articles/PMC3930146/

  15. Gianluca S, Sambataro G, Sambataro D, Torrisi SE, Vancheri A, Colaci M, et al. Clinical, serological and radiological features of a prospective cohort of Interstitial Pneumonia with Autoimmune Features (IPAF) patients. Respir Med. 2019;150:154-60. Disponible en: https://doi.org/10.1016/j.rmed.2019.03.011, https://pubmed.ncbi.nlm.nih.gov/30961944/

  16. Chartrand S, Swigris JJ, Stanchev L, Lee JS, Brown KK, Fischer A. Clinical features and natural history of interstitial pneumonia with autoimmune features: A single center experience. Respir Med. 2016 [Acceso 24/04/2020];119:150-4. Disponible en: Disponible en: https://www.sciencedirect.com/science/article/pii/S0954611116302256

  17. Chung JH, Cox CW, Montner SM, Adegunsoye A, Oldham JM, Husain AN, et al. CT features of the usual interstitial pneumonia pattern: differentiating connective tissue disease -associated interstitial lung disease from idiopathic pulmonary fibrosis. AJR Am J Roentgenol. 2018;210(2):307-13. Disponible en: https://doi.org/10.2214/AJR.17.18384, https://www.ajronline.org/doi/10.2214/AJR.17.18384

  18. Ahmad K, Barba T, Gamondes D, Ginoux M, Khouatra C, Spagnolo P, et al. Interstitial pneumonia with autoimmune features: clinical, radiologic and histological characteristics and outcome in a series of 57 patients. Respir Med. 2017;123:56-62. Disponible en: https://doi.org/10.1016/j.rmed.2016.10.017, https://pubmed.ncbi.nlm.nih.gov/28137497/

  19. Sambataro G, Sambataro D, Torrisi SE, Vancheri A, Pavone M, Rosso R, et al. State of the art in interstitial pneumonia with autoimmune features: A systematic review on retrospective studies and suggestions for further advances. Eur Respir Rev. 2018;2(27):148. Disponible en: https://doi.org/10.1183/16000617.0139-2017, https://err.ersjournals.com/content/27/148/170139.long

  20. Chung JH, Montner SM, Adegunsoye A, Lee C, Oldham JM, Husain AN, et al. CT findings, radiologic-pathologic correlation, and imaging predictors of survival for patients with interstitial pneumonia with autoimmune features. AJR Am J Roentgenol. Jun 2017;208(6):1229-36. Disponible en: https://doi.org/10.2214/AJR.16.17121, https://pubmed.ncbi.nlm.nih.gov/28350485/

  21. Fischer A, Brown KK, Du Bois RM, Frankel SK, Cosgrove GP, Fernandez-Perez ER, et al. Mycophenolate mofetil improves lung function in connective tissue disease-associated interstitial lung disease. J Rheumatol. 2013 [Acceso 26/04/2020];40(5):640-6. Disponible en: Disponible en: https://www.ncbi.nlm.nih.gov/pmc/articles/PMC3676865/

  22. Swigris JJ, Olson AL, Fischer A, Lynch DA, Cosgrove GP, Frankel SK, et al. Mycophenolate mofetil is safe, well tolerated, and preserves lung function in patients with connective tissue disease-related interstitial lung disease. Chest. 2006 [Acceso: 26/04/2020];130(1):30-6. Disponible en: Disponible en: https://doi.org/10.1378/chest.130.1.30, https://pubmed.ncbi.nlm.nih.gov/16840379/

  23. McCoy SS, Mukadam Z, Meyer KC, Sampene E, Kanne JP, Meyer CA, et al. Mycophenolate Mofetil May Improve Interstitial Pneumonia with Autoimmune Features [abstract]. Arthritis Rheumatol. 2017 [Acceso: 24/04/2020];69(suppl 10). Available from: Available from: https://acrabstracts.org/abstract/mycophenolate-mofetil-may-improve-interstitial-pneumonia-with-autoimmune-features/

  24. McCoy SS, Mukadam Z, Meyer KC, Kanne JP, Meyer CA, Martin MD, et al. Mycophenolate therapy in interstitial pneumonia with autoimmune features: A cohort study. Ther Clin Risk Manag. 2018;14:2171-81. Disponible en: https://doi.org/10.2147/TCRM.S173154. https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6219314/




2020     |     www.medigraphic.com