Granulomatosis eosinofílica con poliangitis (GEPA). Jueves 3 de septiembre

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 Granulomatosis eosinofílica con poliangitis (GEPA)



Dra. Natalia Aguirre 

Comentarios

  1. Valeria Zapata Marín3 de septiembre de 2020 a las 15:35

    En los pacientes con sospecha de EGPA, surge una duda y es cómo clasificar a los pacientes con asma y eosinofilia sanguínea, pero sin evidencia definitiva de vasculitis fuera de los pulmones, la nariz y los senos nasales. Una propuesta es que estos pacientes deben cumplir además uno de los siguientes:

    ●Poliangeítis definida: biopsia que muestra vasculitis necrotizante, biopsia que muestra glomerulonefritis necrosante o semilunar, hemorragia alveolar, púrpura palpable o infarto de miocardio debido a coronaritis comprobada.

    ●Supuestos definitivos de la vasculitis: hematuria asociada con cilindros de glóbulos rojos > 10% de eritrocitos dismórficos; hematuria con proteinuria 2+; vasculitis leucocitoclástica / infiltración eosinofílica de una pared arterial en la biopsia

    ●Mononeuritis o mononeuritis múltiple

    ●Anticuerpos anticitoplasma de neutrófilos (ANCA) y manifestaciones sistémicas (p. Ej., Miocarditis, pericarditis, neuropatía periférica, otras enfermedades renales, dolor abdominal)

    En los pacientes que no cumplen con uno de los anteriores, surge una propuesta y es la creación de una categoría denominada “asma hipereosinofílica con manifestaciones sistémicas” para pacientes con asma, hipereosinofilia (≥1500 células / microL y / o ≥10 por ciento de leucocitos), y cualquier manifestación sistémica, pero sin ANCA, poliangeítis definida, una sustituto de poliangeítis o mononeuritis.

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