DOI: https://doi.org/10.7705/biomedica.v38i4.3893

Glomerulonefritis colapsante con marcadores de desdiferenciación podocitaria en síndrome hemofagocítico secundario a linfoma hepatoesplénico de células T

María Adoración Martín-Gómez, Mercedes Caba-Molina, María José Viciana-Martínez-Lage, Rosa Ortega-Salas, Alicia Sánchez-Crespo, Manuel Jesús Soriano-Pérez, Mercedes Gómez-Morales

Resumen


El síndrome hemofagocítico es una condición clínica e histológica grave, secundaria a diferentes procesos. La glomerulonefritis colapsante es una podocitopatía proliferativa, generalmente de pronóstico desfavorable para la función renal. Se presenta un caso en el que las dos condiciones aparecieron asociadas, lo cual es una forma infrecuente de presentación del linfoma hepatoesplénico de células T. Se discute, asimismo, el papel de los marcadores de desdiferenciación podocitaria en esta glomerulopatía, y se revisan la fisiopatología y el tratamiento.

Palabras clave


glomerulonefritis; linfohistiocitosis hemofagocítica; linfoma; insuficiencia renal; antígenos de diferenciación; trastornos linfoproliferativos

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Referencias


1. Fujiwara F, Hibi S, Imashuku S. Hypercytokinemia in hemophagocytic syndrome. Am J Pediatr Hematol Oncol. 1993;15:92-8.
2. Larroche C, Spivak JL. Pathogenesis of hemophagocytic syndrome. Autoimmune Rev. 2004;3:69-75. https://doi.org/10.1016/S1568-9972(03)00091-0
3. D´Agati VD, Fogo AB, Bruijin JA, Jenette JC. Pathologic classification of focal segmental glomerulosclerosis: A working proposal. Am J Kidney Dis. 2004;43:368-82. https://doi.org/10.1053/j.ajkd.2003.10.024
4. Verbsky JM, Grossman WJ. Hemophagocytic lymphohistiocytosis: Diagnosis, pathophysiology, treatment, and future perspectives. Ann Med. 2006;38:20-31. https://doi.
org/10.1080/07853890500465189
5. Kumukura S, Murakawa Y. Clinical characteristics and treatment outcomes of autoimmune-associated hemophagocytic syndrome in adults. Arthritis Rheumatol. 2014;66:2297-307. https://doi.org/10.1002/art.38672
6. Trottestam H, Horne A, Arico M, Egeler RM, Filipovich AH, Gadner H, et al. Chemoimmunotherapy for hemophagocytic lymphohistiocytosis: Long-term results of the HLH-94 treatment protocol. Blood. 2011;118:4577-84. https://doi.org/10.1182/blood-2011-06-356261
7. Aulagnon F, Lapidus N, Canet E, Galicier L, Boutboul D, Peraldi MN, et al. Acute kidney injury in adults with hemophagocytic lymphohistiocytosis. Am J Kidney Dis. 2015;65:851-9. https://doi.org/10.1053/j.ajkd.2014.10.012
8. Karras A. What nephrologists need to know about hemophagocytic syndrome. Nat Rev Nephrol. 2009;5:329-36. https://doi.org/10.1038/nrneph.2009.73
9. Málaga-Dieguez L, Ming W, Trachtman H. Direct reversible kidney injury in familial hemophagocytic lymphohistiocytosis type 3. J Am Soc Nephrol. 2015;26:1777-80. https://doi.org/10.1681/ASN.2014111090
10. Thaunat O, Delahoisse M, Fakhouri F, Martínez F, Stephan JL, Noël LH, et al. Nephrotic syndrome associated with hemophagocytic syndrome. Kidney Int. 2006;69:1892-
8. https://doi.org/10.1038/sj.ki.5000352
11. Esmaili H, Mostafidi E, Mehramuz B, Ardalan M, Mohajel-Shoja M. An update on renal involvement in hemophagocytic syndrome (macrophage activation syndrome). J Nephropathol. 2016;5:8-14. https://doi.org/10.15171/jnp.2016.02
12. Santoriello D, Hogan H, DÁgati VD. Hemophagocytic syndrome with histiocytic glomerulopathy and intraglomerular hemophagocytosis. Am J Kidney Dis. 2016;67:978-83.
https://doi.org/10.1053/j.ajkd.2015.11.017
13. Ponticelli C, Alberighi OD. Haemophagocytic syndrome--a life-threatening complication of renal transplantation. Nephrol Dial Transplant. 2009;24:2623-7. https://doi.org/10.1093/ndt/gfp282
14. Raffray L, Couzi L, Viallard JF, Pellegrin JL, Augis V, Vernant JP, et al. Mycophenolate mofetil: A possible cause of hemophagocytic syndrome following renal transplantation? Am J Transplant. 2010;10:2378-9. https://doi.org/10.1111/j.1600-6143.2010.03254.x
15. Nichols B, Jog P, Lee JH, Blackler D, Wilmot M, Dágit V, et al. Innate immunity pathways regulate the nephropathy gene apolipoprotein L1. Kidney Int. 2015;87:332-42. https://doi.org/10.1038/ki.2014.270
16. Genovese G, Tonna SJ, Know AU, Appel GB, Katz A, Bernhardy AJ, et al. A risk allele for focal segmental glomerulosclerosis in African Americans is located within a region containing APOL1 and MYH9. Kidney Int. 2010;78:698-704. https://doi.org/10.1038/ki.2010.251
17. Redondo-Pachón MD, Ortega-Salas R, Moyano-Peregrin C, López-Andreu M, Espinosa-Hernández M, Romera-Segorbe A, et al. Marcadores de desdiferenciacion podocitaria en un paciente con glomerulonefritis colapsante.Nefrología. 2010;30:360-6. https://doi.org/10.3265/Nefrologia.pre2010.Mar.10325
18. Albaqumi M, Barisoni L. Current views on collapsing glomerulopathy. J Am Soc Nephrol. 2008;19:1276-81. https://doi.org/10.1681/ASN.2007080926
19. Koukouritaki SB, Vardaki EA, Papakonstanti EA, Lianos E, Stournaras C, Emmanouel DS. TNF-alpha induces actin cytoskeleton reorganization in glomerular epithelial cells involving tyrosine phosphorylation of paxillin and focal adhesion kinase. Mol Med. 1999;5:382-92.
20. Markowitz GS, Nasr SH, Stokes MB, D´Agati VD. Treatment with IFN-{alpha}, -{beta}, or -{gamma} is associated with collapsing focal segmental glomerulosclerosis. Clin J Am Soc Nephrol. 2010;5:607-15. https://doi.org/10.2215/CJN.07311009
21. Pavenstadt H, Kriz W, Kretzler M. Cell biology of the glomerular podocyte. Physiol Rev. 2003;83:253-307. https://doi.org/10.1152/physrev.00020.2002
22. Shankland SJ, Eitner F, Hudkins KL, Goodpaster T, D´Agati V, Alpers CE. Differential expression of cyclindependent kinase inhibitors in human glomerular disease: Role in podocyte proliferation and maturation. Kidney Int. 2000;58:674-83. https://doi.org/10.1046/j.1523-1755.2000.00213.x
23. Barisona L, Nelson PJ. Collapsing glomerulopathy: An inflammatory podocytopathy? Curr Opin Nephrol Hypertens. 2007;16:192-5. https://doi.org/10.1097/MNH.0b 013e
32805b726b
24. Schwimmer JA, Markowitz GS, Valeri A, Appel GB. Collapsing glomerulopathy. Semin Nephrol. 2003;23:209-18.
25. Grcevska L, Polenakovik M. Collapsing glomerulopathy: Clinical characteristic and follow-up. Am J Kidney Dis. 1999;33:652-57. https://doi.org/10.1053/snep.2003.50019
26. Kashgary A, Sontrop JM, Li L, Al-Jaishi AA, Habibullah ZN, Alsolaimani R. The role of plasma exchange in treating post-transplant focal segmental glomerulosclerosis: A systematic review and meta-analysis of 77 case-reports and case-series. BMC Nephrol. 2016;17:104. https://doi.org/10.1186/s12882-016-0322-7
27. Asci G, Toz H, Ozkahya M, Cagirgan S, Duman S, Sezis M, et al. High-dose immunoglobulin therapy in renal transplant recipients with hemophagocytic histiocytic syndrome. J Nephrol. 2006;19:322-6.
28. Ferreri AJM, Govi S, Pilari SA. Hepatosplenic gamma-delta T-cell lymphoma. Crit Rev Oncol Hematol. 2012;83:283-292. https://doi.org/10.1016/j.critrevonc.2011.10.001
29. Han AR, Lee HR, Park BB, Hwang IG, Park S, Lee SC, et al. Lymphoma-associated hemophagocytic syndrome: Clinical features and treatment outcome. Ann Hematol. 2007;86:493-8. https://doi.org/10.1007/s00277-007-0278-6
30. Egües-Dubuc C, Aldasoro-Cáceres V, Uriarte-Ecenarro M, Errazquin-Aguirre N, Hernando-Rubio I, Meneses-Villalba CF, et al. Síndrome de activación macrofágica secundario a enfermedades autoinmunes, hematológicas, infecciosas y oncológicas. Serie de 13 casos clínicos y una revisión bibliográfica. Reumatol Clin. 2015;11:139-43. https://doi.org/10.1016/j.reuma.2014.06.007


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Revista Biomédica -  https://doi.org/10.7705/issn.0120-4157
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