Cruz-Contreras DG

Idioma: Español
Referencias bibliográficas: 20
Paginas: 256-261
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RESUMEN

El síndrome antifosfolipídico es una afección caracterizada por producir un estado hipercoagulable mediado por anticuerpos, puede ser primario o secundario a enfermedad reumatológica o neoplásica. Los anticuerpos implicados son las anticardiolipinas (IgG e IgM), antiβ2 glicoproteína 1 y el anticoagulante lúpico. Quien lo padece tiene eventos trombóticos venoarteriales de repetición, que en algunos casos pueden ser de difícil control e incluso mortales. Existen los criterios de Sapporo revisados en 2006 para establecer el diagnóstico; estos criterios incluyen datos clínicos y de laboratorio. Debido a que los eventos trombóticos de estos pacientes tienden a la repetición, el tratamiento es por largo tiempo y en ocasiones de manera indefinida. El tratamiento está encaminado a revertir el estado hipercoagulable, se prescribe de primera línea y en pacientes no embarazadas se prescriben antagonistas de la vitamina K, con INR objetivo en 2.5. En los casos de embarazo o sospecha del mismo el tratamiento se basa en heparina de bajo peso molecular en ocasiones aunado a ácido acetilsalicílico. En la actualidad se publican resultados de los estudios que utilizan como tratamiento los nuevos anticoagulantes orales. Aún se desconoce la necesidad de profilaxis antitrombótica en los pacientes con anticuerpos positivos, pero que aún no han trombosado.

REFERENCIAS (EN ESTE ARTÍCULO)

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19. The US Food and Drug Administration expansion of the approved us of Xarelto (Rivaroxaban) to include treating deep vein thrombosis (DVT) or pulmonary embolism (PE), and to reduce the risk the recurrent DVT and PE following initial treatment. Disponible en: http://www.fda.gov/NewsEvent/ Newroom/PressAnnouncements/ucm326654.htm (November 2012, accessed 31 October 2014).

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