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Infección aguda por el virus de la hepatitis E como desencadenante de nefropatía IgA postinfecciosa: un raro reporte
Musawer Khan1, Zarafshan Khan1, Ashfaq Altaf1
1Department of Nephrology, Combined Military Hospital Quetta, Quetta, Pakistan.
Medicine
|December 30, 2025
Resumen
La infección aguda por el virus de la hepatitis E puede desencadenar nefropatía IgA. El reconocimiento y tratamiento tempranos de esta enfermedad renal en pacientes con VHE mejoran significativamente los resultados y la función renal.
Área de la Ciencia:
- Nefrología
- Enfermedades Infecciosas
- Hepatología
Sus antecedentes:
- La nefropatía IgA (IgAN) es típicamente idiopática, pero puede seguir a infecciones.
- El vínculo entre la IgAN y la infección por el virus de la hepatitis E (VHE) es poco conocido.
- Las asociaciones de la hepatitis B y C con la IgAN son conocidas, pero la asociación con el VHE se describe raramente.
Objetivo del estudio:
- Describir un caso de nefropatía IgA posterior a infección aguda por el virus de la hepatitis E.
- Destacar el papel potencial del VHE como desencadenante de la IgAN postinfecciosa.
- Enfatizar la importancia de considerar la IgAN en pacientes con VHE con disfunción renal.
Principales métodos:
- Un hombre de 37 años presentó síntomas de hepatitis aguda y orina oscura.
- Las pruebas de laboratorio revelaron enzimas hepáticas elevadas, hiperbilirrubinemia y lesión renal aguda con IgM positiva para Hepatitis E.
- La biopsia renal confirmó nefropatía IgA postinfecciosa con hipercelularidad mesangial y lesión tubular aguda.
Principales resultados:
- El paciente recibió atención de apoyo, que incluyó hemodiálisis y corticosteroides.
- La función renal mejoró significativamente en 3 meses, con una disminución de la creatinina sérica de 703 µmol/L a 135 µmol/L.
- Los síntomas se resolvieron y no hubo recurrencia de hematuria o deterioro renal.
Conclusiones:
- La infección aguda por VHE puede desencadenar nefropatía IgA postinfecciosa.
- Los médicos deben sospechar IgAN en pacientes con VHE que presenten disfunción renal.
- El diagnóstico y manejo oportunos de la IgAN asociada a VHE pueden conducir a una recuperación sustancial de la función renal.
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