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La enfermedad de Crohn
Joana Torres1, Saurabh Mehandru1, Jean-Frédéric Colombel1
1Division of Gastroenterology, Icahn School of Medicine at Mount Sinai, New York City, NY, USA.
Lancet (London, England)
|December 5, 2016
Resumen
La enfermedad de Crohn
Área de la Ciencia:
- Gastroenterología e Inmunología
Sus antecedentes:
- La enfermedad de Crohn es una condición inflamatoria gastrointestinal crónica con una incidencia global en aumento.
- Surge de factores genéticos, ambientales y microbianos, que causan una desregulación del sistema inmunológico.
- Los síntomas típicos incluyen dolor abdominal, diarrea, pérdida de peso y fatiga en adultos jóvenes.
Objetivo del estudio:
- Para proporcionar una visión general orientada al médico de la enfermedad de Crohn en adultos.
- Para cubrir la epidemiología, la etiología, el diagnóstico, la historia natural y el tratamiento.
- Para discutir las terapias emergentes y las direcciones futuras de la investigación.
Principales métodos:
- Este seminario sintetiza el conocimiento actual sobre la enfermedad de Crohn.
- Se examinan los criterios de diagnóstico y los factores de pronóstico.
- Se describen las estrategias de tratamiento actuales y emergentes.
Principales resultados:
- La gestión eficaz requiere evaluar la extensión de la enfermedad y los factores de pronóstico para tomar decisiones terapéuticas oportunas.
- Las estrategias actuales se centran en lograr una remisión profunda mediante inmunosupresión temprana o terapia combinada en pacientes de alto riesgo.
- Un enfoque de tratamiento al objetivo con monitoreo frecuente y ajuste de la terapia es fundamental.
Conclusiones:
- La expansión de las opciones terapéuticas requiere biomarcadores para predecir la respuesta al tratamiento y permitir la medicina personalizada.
- El tratamiento temprano y agresivo, incluidos los biológicos y una estrategia de tratamiento al objetivo, es crucial para prevenir las complicaciones y la progresión de la enfermedad.
- La investigación en curso es vital para avanzar en el cuidado de la enfermedad de Crohn y los resultados de los pacientes.
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