medigraphic.com

2006, Número 3

<< Anterior Siguiente >>

Rev Med Inst Mex Seguro Soc 2006; 44 (3)


Granulomatosis de Wegener: estado de portador de Staphylococcus aureus y terapéutica combinada

Cervera-Castillo H, Torres-Caballero V, Martínez-García E, Pizaña-Serna M, Blanco-Favela FA

Idioma: Español
Referencias bibliográficas: 21
Paginas: 249-255
Archivo PDF: 187.09 Kb.


RESUMEN

Se presenta una serie de cinco casos con granulomatosis de Wegener, dos mujeres y tres hombres, con edad promedio de 37 años, tiempo de evolución de la enfermedad de cinco años, presentación clínica sistémica (afección respiratoria, renal, ocular) y anticuerpos anticitoplasma de neutrófilo positivos; tres pacientes fueron portadores de Staphylococcus aureus. Todos recibieron terapia combinada con trimetoprim-sulfametoxazol-ciclofosfamida durante aproximadamente 29 meses de seguimiento, excepto una mujer por gravidez. Los pacientes mostraron evolución clínica satisfactoria. Se sugiere que por sus beneficios, la combinación de trimetoprim-sulfametoxazol-ciclofosfamida puede ser útil como alternativa terapéutica en granulomatosis de Wegener.


REFERENCIAS (EN ESTE ARTÍCULO)

  1. 1. Fauci AS, Haynes BF, Katz P, Wolff SM. Wegener’s granulomatosis: prospective clinical and thera-peutic experience with 85 patients for 21 years. Ann Intern Med 1983;98:76-85.

  2. 2. Hoffman GS, Kerr GS, Leavitt RY, Hallahan CW, Lebovics RS, Travis WD, et al. Wegener granulo-matosis: an analysis of 158 patients. Ann Intern Med 1992;116:488-498.

  3. 3. Reinhold-Keller E, Beuge N, Latza U, de Groot K, Rudert H, Nölle B, et al. An interdisciplinary ap-proach to the care of patients with Wegener’s granu-lomatosis. Arthritis Rheum 2000;43:1021-1032.

  4. 4. Specks U, Fervenza FC, McDonald TJ, Hogan MC. Response of Wegener’s granulomatosis to anti-CD20 chimeric monoclonal antibody therapy. Arthritis Rheum 2001;44:2836-2840.

  5. 5. DeRemee RA. The treatment of Wegener’s granu-lomatosis with trimethoprim/sulfametoxazole: illusion or vision? Arthritis Rheum 1988;31:1068-1072.

  6. 6. Stegeman CA, Cohen-Tervaert JW, Sluiter WJ, Manson WL, Jong PE, Kallenberg CG, et al. Asso-ciation of chronic nasal carriage of Staphylococcus aureus and higher relapse rates in Wegener granu-lomatosis. Ann Intern Med 1994;120:12-17.

  7. 7. Ropa ER, Stegeman CA, Bos NA, Manson WM, Arends J, Johnson WM, et al. Staphylococcal superantigens: a risk factor for disease reactivation in Wegener’s granulomatosis. Arthritis Rheum 1999;42: (Suppl 11):S283.

  8. Guillevin L, Cordier JF, Lhote F, Cohen P, Jarrousse B, Royer I, et al. A prospective, multicenter, ran-domized trial comparing steroids and pulse cyclo-phosphamide in the treatment of generalized Wegener’s granulomatosis. Arthritis Rheum 1997; 40:2187-2198.

  9. DeGroot K, Reinhold-Keller E, Tatsis E, Paulsen J, Heller M, Nölle B, et al. Therapy for the maintenance of remission in sixty-five patients with generalized Wegener’s granulomatosis. Arthritis Rheum 1996; 39:2052-2061.

  10. Stegeman CA, Cohen-Tervaert JW, de Jong PE, Kallenberg GM. Trimethoprim/sulfamethoxazole (Co-trimoxazole) for the prevention of relapses of Wegener’s granulomatosis. Disponible en: http://content.nejm.org/cgi/content/abstract/335/1/16?ijkey=PYF5exIyemeA2

  11. Abdou NI, Kullman GJ, Hoffman GS, Sharp GC, Specks U, McDonald T, et al. Wegener’s granulo-matosis: survey of 701 patients in North America. Changes in outcome in the 1990s. J Rheumatol 2002;29:309-316.

  12. Booth A, Harper L, Hammad T, Bacon P, Griffith M, Levy J, et al. Prospective study of TNF-alpha blockade with infliximab in anti-neutrophil cyto-plasmic antibody-associated systemic vasculitis. J Am Soc Nephrol 2004;15:717-721.

  13. Stone JH, Uhfelder ML, Hellmann DB, Crook S, Bedocs NT, Hoffman G. Etanercept combined with convencional treatment in Wegener’s granu-lomatosis: a six-month open-label trial to evaluate safety. Arthritis Rehum 2001;44:1149-1154.

  14. Leavitt RY, Fauci AS, Bloch DA, Michel BA, Hunder GG, Arend WP, et al. The American Collage of Rheumatology 1990 criteria for the classification of Wegener’s granulomatosis. Arthritis Rheum 1990;33:1101-1107.

  15. Somer T, Finegold SM. Vasculitides associated with infections, immunization, and antimicrobial drugs. Clin Infect Dis 1995;20:1010-1036.

  16. Johnson MJ. Obstetric complications and rheumatic disease. Rheumatic Dis Clin North Am 1997:23: 169-182.

  17. Flores-Suárez LF. ANCAS: ¿una, dos o tres parcas? Rev Invest Clin 2001;53:159-173.

  18. Valeriano-Marcet J, Spiera H. Treatment of Wegener’s granulomatosis with sulfametoxazole-trimethoprim. Arch Intern Med 1991;151:1649-1652.

  19. Langford CA, Talar-Williams C, Barron K, Sneller MC. A staged approach to treatment of Wegener’s granulomatosis. Arthritis Rheum 1999;42:2666-2673.

  20. Boomsa MM, Steeman CA, Oost van der L, Hermans J, Kallenberg CG, Limburg PC, et al. Prediction of relapses in Wegener’s granulomatosis by measurement of antineutrophil cytoplasmic antibody levels. Arthritis Rheum 2000;43:2025-2033.

  21. Chung JB, Armstrong K, Schwartz JS, Albert D. Cost-effectiveness of prophylaxis against Pneumo-cystis carinii pneumonia in patients with Wegener’s granulomatosis undergoing immunosuppressive therapy. Arthritis Rheum 2000;43:1841-1848.




2020     |     www.medigraphic.com