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Crisis renal de esclerodermia con sobreposición a dermatomiositis provocada por la infección por COVID-19: un informe

Takuya Kakutani¹, Hideaki Harada¹, Yutaro Imoto¹

¹Department of Rheumatology, Shonan Kamakura General Hospital, 1370-1 Okamoto, Kamakura-shi, Kanagawa, 247-8533, Japan.

Modern rheumatology case reports

|September 6, 2025

Resumen

Este estudio informa de un raro caso de esclerodermia crisis renal provocada por la infección por SARS-CoV-2 en un paciente con dermatomiositis preexistente. Los hallazgos ponen de relieve un vínculo potencial entre el virus y esta complicación grave, posiblemente involucrando el sistema renina-angiotensina.

Área de la Ciencia:

Reumatología
Enfermedades infecciosas
Nefrología

Sus antecedentes:

Un hombre de 46 años con dermatomiositis positiva por anticuerpos anti-Jo-1 desarrolló disnea severa, insuficiencia renal y cardíaca después de la infección por SARS-CoV-2.
El paciente fue tratado previamente con prednisolona y tacrolimus para la dermatomiositis.

Objetivo del estudio:

Para investigar un caso raro de crisis renal de esclerodermia potencialmente desencadenado por la infección por SARS-CoV-2.
Explorar la relación entre la infección por SARS-CoV-2 y la crisis renal de la esclerodermia, teniendo en cuenta el sistema renina-angiotensina.

Principales métodos:

Presentación y análisis del caso clínico.
Biopsia de las áreas afectadas.
Pruebas serológicas de autoanticuerpos (anti-U1-RNP).
Biopsia renal para evaluar la patología.

Principales resultados:

Diagnóstico de esclerosis sistémica y esclerodermia renal confirmado por biopsia y positividad de anticuerpos anti-U1-RNP.
La biopsia renal reveló atrofia tubular, restos de células intratubulares y daño de células endoteliales consistentes con la crisis renal de la esclerodermia.
El paciente requirió hemodiálisis debido a insuficiencia renal.

Conclusiones:

La crisis renal de esclerodermia provocada por la infección por SARS-CoV-2 es un evento nuevo y extremadamente raro.
Se sugiere un posible vínculo entre la infección por SARS-CoV-2 y la crisis renal de la esclerodermia, posiblemente mediada por el sistema renina-angiotensina.

Palabras clave:

Anticorpo contra el U1-RNP Sistema de la renina y la angiotensina El virus del SARS-CoV-2 Esclerodermia y crisis renal Esclerosis sistémica

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