Autoanticuerpos y vasculitis sistémicas
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https://doi.org/10.31053/1853.0605.v67.n4.22576Palavras-chave:
autoanticuerpos, vasculitis sistémicasResumo
El término vasculitis incluye un grupo heterogéneo de enfermedades que tienen en común la lesión inflamatoria de los vasos sanguíneos. La evolución de este proceso inflamatorio conduce a la isquemia o, en ocasiones, hemorragia de los órganos dependientes de esos vasos. La localización de los vasos y los tejidos afectados van a determinar la aparición de una amplia variedad de manifestaciones clínicas y, por tanto, de un pronóstico también muy variable. Las distintas entidades agrupadas bajo el término de vasculitis incluyen la granulomatosis de Wegener, el síndrome de Churg-Strauss, panarteritis nodosa clásica, poliangeítis microscópica, enfermedad de Kawasaki y vasculitis leucocito clásticas que afectan predominantemente a vasos de mediano y pequeño tamaño. La arteritis de células gigantes y la arteritis de Takayasu afectan sobre todo a vasos de gran tamaño. Podemos encontrar vasculitis primarias (sin asociación con otra enfermedad subyacente) o secundarias tanto a procesos infecciosos como a enfermedades autoinmunes (artritis reumatoide, lupus eritematoso sistémico, etc.). Los anticuerpos anticitoplasma de neutrófilo (ANCA) fueron descriptos inicialmente por Davies et al. (2) en pacientes con glomerulonefritis. Están dirigidos contra enzimas presentes en los gránulos azuròfilos de los neutrófilos (3,4). Trabajos posteriores han confirmado su asociación con la granulomatosis de Wegener (5,6), con la poliangeítis microscópica, glomerulonefritis idiopática necrotizante y otras enfermedades autoinmunes.
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