Palavras-chave
tuberculosis extrapulmonar
adenosina deaminasa.
Como Citar
Resumo
El síndrome hemofagocítico (SHF) o linfohistiocitosis hemofagocítica (LHH) se caracteriza por una activación y proliferación de linfocitos o histiocitos, los cuales secundariamente presentan hemofagocitosis no controlada y sobreproducción de citocinas. Síntomas como fiebre de inicio agudo, linfadenopatía generalizada, hepatoesplenomegalia, hipofibrinogenemia e hipertrigliceridemia caracterizan el síndrome. Su etiología puede ser primaria o secundaria. La LHH primaria está relacionada con factores genéticos; la secundaria está asociada a procesos infecciosos, neoplásicos o autoinmunes. Es un síndrome clínico potencialmente mortal que se produce en todos los grupos de edad. La LHH es la consecuencia de una reacción hiperinflamatoria aguda e incontrolada, que en la mayoría de los casos es provocada por un agente infeccioso. Ocurre con predominio en pacientes inmunocomprometidos y habitualmente es fatal. La gran mayoría de casos están reportados con infecciones por herpes virus. Sin embargo, una gran cantidad de microrganismos se asocian a su etiología. La tuberculosis es una infección poco descrita como causa de LHH secundario. Su diagnóstico como etiología asociada es complejo y muy difícil. La posibilidad de encontrar el Mycobacterium tuberculosis en los cultivos de muestras de tejido y líquido pleural es muy limitada, dado que la tuberculosis extrapulmonar es un proceso paucibacilar. Dentro de las herramientas diagnósticas disponibles, la medición de las concentraciones de adenosindeaminasa en el líquido pleural tiene una sensibilidad diagnóstica adecuada. Sus valores de corte siguen siendo materia de controversia.
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