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La incidencia de la eosinofilia en el dolor crónico refractario que requiere neuromodulación
Emma C Sargent1, Hanna Johnson2, Avantika Mitbander2
1Florida Atlantic University Charles E. Schmidt College of Medicine, Boca Raton, FL, USA.
Neuromodulation : journal of the International Neuromodulation Society
|September 2, 2025
Resumen
La eosinophilia, una condición con niveles elevados de eosinófilos, se produjo en el 12,3% de los pacientes sometidos a estimulación de la médula espinal o a implantación intratecal de la bomba de fármacos para el dolor crónico. Este hallazgo sugiere un vínculo potencial entre la eosinofilia y el estado inmunológico del dolor crónico, sin resultados adversos.
Área de la Ciencia:
- Neurología
- Inmunología
- Tratamiento del dolor
Sus antecedentes:
- La eosinofilia está asociada con varias enfermedades, pero su relación con el dolor crónico no está bien establecida.
- La neuromodulación, incluida la estimulación de la médula espinal (SCS) y las bombas de medicamentos intratecales (ITP), se utiliza para el dolor crónico de alto impacto.
Objetivo del estudio:
- Investigar la incidencia y la relevancia clínica de la eosinofilia en pacientes sometidos a implantación de SCS o ITP para el dolor crónico.
- Para determinar si la eosinofilia está asociada con datos demográficos, diagnósticos o resultados específicos de los pacientes después de la neuromodulación.
Principales métodos:
- Revisión retrospectiva de 114 pacientes sometidos a implantación de SCS o ITP (2017-2024).
- Eosinophilia definida como el recuento absoluto de eosinófilos (AEC) ≥350 células/μL.
- Comparación de datos demográficos, clínicos y de laboratorio entre pacientes con y sin eosinofilia.
Principales resultados:
- El 12,3% de los pacientes exhibió eosinofilia (media de AEC 547 células/μL frente a 138 células/μL).
- No se observaron diferencias significativas en edad, sexo, tipo de implante, diagnósticos o mejoría del dolor entre los grupos.
- Se observaron comorbilidades como migrañas y asma en el grupo eosinofílico; no se produjeron complicaciones a corto plazo ni cirugías de revisión.
Conclusiones:
- La eosinofilia es más frecuente en pacientes con dolor crónico sometidos a neuromodulación que en la población general.
- La eosinofilia en este contexto no está relacionada con resultados adversos a corto plazo.
- Puede indicar un estado inmunológico subyacente asociado con dolor crónico de alto impacto.
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