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Grosor coroideo en nefritis lúpica activa

Letícia Maria Kolachinski Raposo Brandão1, Lucas Parente de Andrade2, Débora Cordeiro do Rosário1

  • 1Division of Rheumatology, Faculdade de Medicina, Hospital Das Clínicas, Universidade de São Paulo, São Paulo, Brazil.

Lupus
|January 9, 2026
PubMed
Resumen

Los pacientes con nefritis lúpica (NL) activa presentan una reducción del grosor coroideo (GC). Este hallazgo sugiere que la coroides es un órgano diana subclínico en la NL, y el GC puede ayudar a monitorizar la actividad de la enfermedad de forma no invasiva.

Palabras clave:
nefritis lúpica activacoroidestomografía de coherencia óptica

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Área de la Ciencia:

  • Oftalmología
  • Nefrología
  • Reumatología

Sus antecedentes:

  • La coroidopatía lúpica está relacionada con la actividad severa del lupus eritematoso sistémico (LES) y la nefritis lúpica (NL).
  • La relación entre el grosor coroideo (GC) y la afectación vascular glomerular o la actividad de la NL sigue siendo objeto de debate.
  • Este estudio investiga el GC en pacientes con NL activa antes del tratamiento.

Objetivo del estudio:

  • Evaluar el grosor coroideo (GC) en pacientes con nefritis lúpica (NL) activa.
  • Comparar el GC en pacientes con NL activa con un grupo de control sano.
  • Explorar el GC como un posible indicador de la actividad de la NL.

Principales métodos:

  • Un estudio transversal de casos y controles que involucró a 28 pacientes con NL activa y controles sanos.
  • Los pacientes cumplieron los criterios ACR/EULAR 2019 para LES; la NL se confirmó mediante biopsia renal en 20 pacientes.
  • El grosor coroideo (GC) se midió utilizando tomografía de coherencia óptica de dominio de barrido (SD-OCT).

Principales resultados:

  • Los pacientes con NL y los controles tuvieron una distribución de edad y sexo similar.
  • Los pacientes con NL exhibieron un grosor coroideo central subfoveal (GC) medio significativamente menor en comparación con los controles (329 ± 69,9 μm frente a 297 ± 41,7 μm, p=0,004).
  • Los parámetros renales mostraron una creatinina media de 0,80 ± 0,26 mg/dL y una relación proteína/creatinina de 1,84 ± 1,70 g/g.

Conclusiones:

  • La reducción del GC central subfoveal en pacientes con NL activa sugiere que la coroides es un órgano diana subclínico de la inflamación sistémica.
  • La medición del GC es una herramienta prometedora y no invasiva para monitorizar la actividad de la NL.
  • Se necesitan más estudios longitudinales para confirmar la utilidad del GC como biomarcador para el manejo de la NL.