2018, Número 3
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Med Int Mex 2018; 34 (3)
Síndrome hemolítico urémico atípico: papel del perfil genético
Roldán-Tabares MD, Ruiz-Mejía C
Idioma: Español
Referencias bibliográficas: 46
Paginas: 394-402
Archivo PDF: 397.68 Kb.
RESUMEN
El síndrome hemolítico urémico es una microangiopatía trombótica caracterizada por
anemia hemolítica microangiopática, trombocitopenia y daño renal agudo. El síndrome
hemolítico urémico típico (el más común) es ocasionado por bacterias productoras de
la toxina Shiga, típicamente por cepas de
Escherichia coli. El término síndrome hemolítico
urémico atípico se usa para referirse a los pacientes que padecen este cuadro
por causas diferentes. Las manifestaciones clínicas y paraclínicas no son suficientes
para diferenciar el síndrome hemolítico urémico atípico de otras microangiopatías
trombóticas, por lo que la determinación de la actividad de ADAMTS13 y la prueba
de la toxina Shiga resultan esenciales para establecer el diagnóstico preciso. Aunque
en la actualidad el diagnóstico definitivo requiere confirmación genética, las pruebas
genéticas son costosas y poco útiles para el diagnóstico inicial; sin embargo, más que
importancia diagnóstica, tiene gran valor pronóstico, permite prescribir el tratamiento
adecuado disminuyendo significativamente la morbilidad y mortalidad atribuibles a
esta enfermedad.
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