RESUMEN
The term autoimmune cytopenias is referred to a heterogeneous group of diseases characterized by a reduced peripheral blood cell counts in one or more cellular series, because an immunological disorder. The first line therapy is steroids, followed by splenectomy or immunesupressant therapy in non-responders. Rituximab is an anti CD20 monoclonal antibody used as a third line in refractory patients or as an alternative to splenectomy. We present a retrospective study of nine patients with autoimmune cytopenias treated in a public hospital setting with rituximab. Five patients with the diagnosis of inmune thrombocytopenic purpura received it, all of them achieved hematological response (4 complete and one partial). The median time to the best response was 6 weeks, staying in this category after 6 months of follow up. Four patients with autoimmune hemolytic anemia received rituximab, three of them achieving partial response and one was lost from follow up. No severe adverse effects related to rituximab were registered.
Asunto(s)
Humanos , Masculino , Femenino , Adulto , Persona de Mediana Edad , Anciano , Enfermedades Autoinmunes/tratamiento farmacológico , Trombocitopenia/tratamiento farmacológico , Anticuerpos Monoclonales de Origen Murino/uso terapéutico , Factores Inmunológicos/uso terapéutico , Anemia Hemolítica Autoinmune/tratamiento farmacológico , Neutropenia/tratamiento farmacológico , Estudios Retrospectivos , Púrpura Trombocitopénica Idiopática/inmunología , Rituximab/administración & dosificaciónRESUMEN
Las citopenias hematológicas son un hallazgo frecuente y potencialmente grave en las Enfermedades Autoinmunes Sistémicas. Sus causas pueden ser muy variadas, de ahí la importancia de un abordaje diagnóstico sistematizado que asegure además el tratamiento correcto. En este artículo se revisan las generalidades de las citopenias hematológicas en cuanto a frecuencia, causas, así como su enfoque diagnóstico y terapéutico.
The hematologic cytopenias are a frequent and potentially dangerous finding in the Systemic Autoimmune Diseases. It may have different etiologies, and for that reason it is important a systematic approach to ensure the correct diagnosis and treatment. In this article, the frequency, etiology, diagnostic approach and treatment of the hematologic cytopenias are reviewed.