Necrose de medula óssea em paciente portadora de lúpus eritematoso sistêmico

Cláudia Hilbig; José Victor Martinez; José Eduardo Martinez

doi:10.5327/Z1984-4840201625947

Autores

Cláudia Hilbig PUC-SP/FCMS
José Victor Martinez PUC-SP/FCMS
José Eduardo Martinez PUC-SP/FCMS

DOI:

https://doi.org/10.5327/Z1984-4840201625947

Palavras-chave:

lúpus eritematoso sistêmico, pancitopenia, necrose, medula óssea

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.

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Biografia do Autor

Cláudia Hilbig, PUC-SP/FCMS

Especializanda em Reumatologia

José Victor Martinez, PUC-SP/FCMS

Estudante de Medicina

José Eduardo Martinez, PUC-SP/FCMS

Titular do Departamento de Medicina

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