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El síndrome de los antifosfolípidos
Guillermo Ruiz-Irastorza1, Mark Crowther, Ware Branch
1Service of Internal Medicine, Hospital de Cruces-University of the Basque Country, Bizkaia, Spain. r.irastorza@euskalnet.net
Lancet (London, England)
|September 9, 2010
Resumen
El síndrome antifosfolípido (APS) implica trombosis y complicaciones del embarazo. El manejo efectivo incluye anticoagulantes, aspirina y heparina, con investigaciones en curso sobre nuevas terapias como estatinas y rituximab.
Área de la Ciencia:
- Inmunología Inmunología.
- Hematología Hematología.
- Obstetrías y Obstetricia.
Sus antecedentes:
- El síndrome antifosfolípido (APS) se caracteriza por la trombosis y la morbilidad del embarazo.
- Las características clínicas incluyen trombosis venosa, arterial y de vasos pequeños, pérdida del embarazo y preeclampsia.
- La patogénesis involucra anticuerpos antifosfolípidos que activan las células endoteliales, plaquetas y monocitos, lo que potencialmente implica la activación del complemento.
Objetivo del estudio:
- Revisar las manifestaciones clínicas, la patogénesis y el manejo del síndrome antifosfolípido.
- Para resaltar el papel del anticoagulante del lupus como predictor de las características del SPA.
- Discutir las terapias actuales y potenciales futuras para el SPA.
Principales métodos:
- Revisión de la literatura sobre el síndrome antifosfolípido.
- Análisis de los mecanismos patógenos que involucran anticuerpos y complementos.
- Evaluación de estrategias terapéuticas para la trombosis y las complicaciones obstétricas.
Principales resultados:
- El anticoagulante del lupus es el predictor más fuerte de las características del SPA.
- La anticoagulación oral a largo plazo es la piedra angular para la terapia de la trombosis.
- La aspirina y la heparina se recomiendan para el manejo obstétrico del SPA.
Conclusiones:
- El SPA requiere un tratamiento agresivo para los eventos arteriales y la tromboprofilaxis en grupos específicos de pacientes.
- El manejo médico-obstétrico combinado es crucial para las pacientes embarazadas.
- Las terapias futuras pueden incluir estatinas, rituximab y nuevos anticoagulantes.
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