Necrose de medula óssea em paciente portadora de lúpus eritematoso sistêmico

Cláudia Hilbig, José Victor Martinez, José Eduardo Martinez

Resumo


As manifestações hematológicas do lúpus eritematoso sistêmico (LES) são causas de morbidade e risco aumentado de mortalidade global. Paciente jovem, mulher, com LES e síndrome antifosfolípide (SAF) apresentou pancitopenia severa após infecção urinária. A biópsia de medula óssea (MO) mostrou necrose e fibrose reticulínica. O mecanismo mais comum de pancitopenia é a produção de anticorpos periféricos. No entanto, pode ocorrer raramente com aplasia ou necrose de MO. Necrose de MO é mais frequentemente associada a doenças neoplásicas, infecções severas e anemia falciforme, mas também é descrita em pacientes com LES. Tal necrose é vista, mais raramente, em pacientes com SAF primária. Alterações na microcirculação da MO levam a isquemia necrose. As principais complicações na necrose de MO são pancitopenia e embolia. Poucos estudos da literatura apontam a necrose de medula óssea como causa de pancitopenia em pacientes lúpicos. A necrose de MO é uma entidade relativamente rara e de mau prognóstico.

Palavras-chave


lúpus eritematoso sistêmico; pancitopenia; necrose; medula óssea

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Referências


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DOI: http://dx.doi.org/10.5327/Z1984-4840201625947

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