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Síndrome torácico agudo en la enfermedad de células falciformes
Lancet (London, England)
|January 7, 1984
Resumen
El síndrome torácico agudo (SAA) en la enfermedad de células falciformes a menudo se presenta de manera sutil. La enfermedad pulmonar bilateral en rayos X indica una enfermedad grave, pero una transfusión de intercambio rápida puede mejorar significativamente los resultados.
Área de la Ciencia:
- Hematología Hematología.
- Pulmonología Pulmonología.
- Medicina interna es la medicina interna de las enfermedades.
Sus antecedentes:
- El síndrome torácico agudo (STA) es una complicación común y grave en pacientes adultos con enfermedad de células falciformes.
- Los signos clínicos tempranos y los hallazgos radiológicos de ACS pueden ser inespecíficos, lo que complica el diagnóstico y el manejo oportunos.
Objetivo del estudio:
- Para analizar retrospectivamente la presentación clínica, los hallazgos radiológicos y los resultados de los episodios de síndrome torácico agudo en pacientes adultos con enfermedad de células falciformes.
- Para identificar los factores asociados con la gravedad de la enfermedad y la respuesta al tratamiento en ACS.
Principales métodos:
- Revisión retrospectiva de 25 episodios consecutivos de SCA en 13 pacientes adultos con enfermedad de células falciformes.
- Análisis de la presentación de síntomas, signos torácicos, hallazgos de la radiografía torácica, datos de laboratorio y intervenciones de tratamiento.
Principales resultados:
- Los síntomas torácicos estuvieron presentes en la admisión en los episodios 23/25, pero los signos torácicos anormales y las radiografías fueron menos frecuentes inicialmente.
- Los cambios radiológicos bilaterales se asociaron con pulsaciones más altas, fiebre prolongada, hipoxemia severa y mayores caídas de hemoglobina.
- Dos muertes ocurrieron en pacientes con enfermedad bilateral y bajo recuento de plaquetas; 11/12 pacientes mejoraron con transfusión de intercambio.
Conclusiones:
- El falciforme intravascular pulmonar es un posible contribuyente a la presentación clínica del SCA.
- La participación radiológica bilateral significa un episodio de ACS más grave que requiere un manejo agresivo.
- La transfusión de intercambio es un tratamiento eficaz para el SCA grave en la enfermedad de células falciformes.
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