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2013, Número 3

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Rev Cubana Hematol Inmunol Hemoter 2013; 29 (3)


La drepanocitosis y el asma bronquial

Gutiérrez-Díaz AI, Arencibia-Núñez A, Ramón-Rodriguez LG, Eva-Svarch, Jaime-Fagundo JC, Machín-García S, Menendez-Veitía A, Anoceto-Martínez A, Delgado-Vargas T, Serrano-Mirabal J, Valdés CF, González-Otero A

Idioma: Español
Referencias bibliográficas: 62
Paginas:
Archivo PDF: 96.06 Kb.


RESUMEN

El diagnóstico del asma en niños y adultos con drepanocitosis se ha asociado a un aumento de las crisis de dolor y del síndrome torácico agudo, así como a un mayor riesgo de muerte y una menor expectativa de vida. No está bien definido el mecanismo por el cual el asma influye en la drepanocitosis y su prevalencia en esta entidad es muy variable. Ambas son enfermedades inflamatorias y sus mediadores, así como las alteraciones en la vía del óxido nítrico contribuyen a su fisiopatología. La hipovitaminosis D que ocurre en la drepanocitosis se relaciona con la severidad del asma, con una respuesta disminuida a los esteroides y pudiera contribuir a la elevada morbilidad en estos pacientes. La hiperreactividad de las vías aéreas es frecuente en la drepanocitosis, así como las alteraciones de las pruebas funcionales respiratorias. El patrón obstructivo pulmonar está asociado con un mayor número de hospitalizaciones por síndrome torácico agudo y crisis vasoclusivas dolorosas, y a un mayor riesgo de muerte. Por otra parte, el acetaminofén se asocia a un aumento del riesgo de asma y se utiliza con frecuencia en los episodios dolorosos en la drepanocitosis, por lo tanto debe investigarse si existe alguna relación entre su uso en la drepanocitosis y la prevalencia del asma. El diagnóstico y tratamiento adecuado del asma puede disminuir su impacto en la drepanocitosis.


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