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Lesiones pulmonares difusas causadas por vasculitis asociada a la ANCA: un informe de caso
Huiying Chen1, Zehui Lin2, Xiaoyun Jian2
1The Eighth Clinical Medical College of Guangzhou University of Chinese Medicine, Guangzhou, Guangdong, China.
Medicine
|August 27, 2025
Resumen
La vasculitis asociada a anticuerpos citoplasmáticos antineutrófilos (AAV, por sus siglas en inglés) puede imitar las infecciones respiratorias, retrasando el diagnóstico. Las pruebas tempranas de anticuerpos y la atención multidisciplinaria son vitales para el tratamiento inmediato y la mejora de los resultados en los pacientes con AAV.
Área de la Ciencia:
- Reumatología
- Pulmonología
- Inmunología
Sus antecedentes:
- La vasculitis asociada a anticuerpos citoplasmáticos antineutrófilos (AAV, por sus siglas en inglés) comprende enfermedades autoinmunes multisistémicas raras.
- La afectación respiratoria es común en AAV, a menudo presentándose como síntomas similares a las infecciones.
- Los retrasos en el diagnóstico de AAV pueden ocurrir debido a los difíciles hallazgos por imágenes de la hemorragia alveolar.
Objetivo del estudio:
- Para resaltar los desafíos de diagnóstico en la identificación de AAV.
- Hacer hincapié en la importancia de la colaboración multidisciplinaria temprana en el diagnóstico de AAV.
- Para presentar un caso de AAV con presentación respiratoria atípica.
Principales métodos:
- Una paciente de mediana edad presentó síntomas respiratorios persistentes que no respondieron a los antibióticos.
- El diagnóstico incluyó una tomografía computarizada del tórax y pruebas de anticuerpos contra la mieloperoxidasa (MPO-IgG).
- La consulta multidisciplinaria confirmó el diagnóstico de AAV.
Principales resultados:
- El paciente recibió tratamiento con prednisona y azatioprina.
- Se observó una mejoría sintomática en una semana.
- Las imágenes de seguimiento demostraron la completa resolución de las lesiones pulmonares después de tres meses.
Conclusiones:
- Se debe considerar la administración de AAV en pacientes con síntomas respiratorios inexplicables y cambios pulmonares que no respondan a los antibióticos.
- La prueba temprana de anticuerpos citoplasmáticos anti-neutrófilos es crucial para el diagnóstico oportuno de AAV.
- La colaboración multidisciplinaria ayuda significativamente en el diagnóstico y el tratamiento rápidos de AAV.
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