Anemia hemolítica autoinmune como forma de presentación de enfermedad inflamatoria del intestino
Abstract
Las anemias hemolíticas autoinmunes son las caracterizadas por la destrucción de los hematíes debida a la producción de autoanticuerpos por el paciente, dirigidos contra sus propios antígenos eritrocitarios. La asociación con enfermedad inflamatoria del intestino está descrita, pero no es de las asociaciones más frecuentes. Se presenta un caso de una paciente de 64 años de edad, que acude por diarreas y decaimiento, aparecen evolutivamente durante su ingreso lesiones ulceradas orales y perianales. Los exámenes complementarios mostraron una anemia hemolítica Coombs positiva. Los estudios endoscópicos del tubo digestivo, mostraron ulceración continua de todo el colon desde el ciego hasta el ano y pérdida de las austras, imagenológicamente se hizo evidente el aumento de tamaño del bazo en el curso de la hemólisis. Recibió tratamiento con esteroides y mesalazina por vía oral, desaparecieron las manifestaciones de hemólisis extravascular y mejoró la sintomatología digestiva. Se concluyó histológicamente como una enfermedad inflamatoria intestinal tipo colitis ulcerosa.Downloads
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References
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2. Seung-Woo B, Myung-Won L, Hae-Won R, Kyu-Seop L, Ik-Chan S, Hyo-Jin L, et al. Clinical features and outcomes of autoimmune hemolytic anemia: a retrospective analysis of 32 cases. Korean J Hematol. 2011;46:111-7.
3. Panés Díaz J. Enfermedad inflamatoria del intestino. En: Farreras Valenti P, Rozman C, Cardellach López F. Tratado de Medicina Interna. 17a. ed. Barcelona España: Elsevier; 2012. p. 165-76.
4. Snook JA, De Silva HJ, Jewell DP. The association of autoinmune disorders with inflammatory bowel disease. J Med. 1989;72:835-40.
5. Lorber M, Schwartz LI, Wasserman LR. Association of antibody-coated red blood cells with ulcerative colitis. Am J Med. 1955;19:887-96.
6. Ng J-P, Soliman A, Kumar B, Chan Lam D. Auto-immune haemolytic anaemia and Crohn's disease: a case report and review of the literature. Eur J Gastroenterol Hepatol. 2004;16:417-9.
7. Yates P, Macht LM, Williams NA, Elson CJ. Red cell autoantibody production by colonic mononuclear cells from a patientwith ulcerative colitis and haemolytic anaemia. Br J Haematol. 1992;82:753-6.
8. Tavarela F, Fraga J, Carvalho J, Dias LM, Céu M. Autoimmune hemolytic anemia in ulcerative colitis. A case report with review of the literature. J Clin Gastroenterol. 1991;13:445-7.
Published
2017-08-25
How to Cite
1.
Miró Jiménez Y, Castro Jorge M, Allué Flores L. Anemia hemolítica autoinmune como forma de presentación de enfermedad inflamatoria del intestino. Rev Cubana Med Milit [Internet]. 2017 Aug. 25 [cited 2025 Jan. 9];46(2). Available from: https://revmedmilitar.sld.cu/index.php/mil/article/view/33
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Case Presentation
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