Síndrome pulmón-riñón en pacientes con hallazgos incidentales de agentes infecciosos
Resumen
El síndrome pulmón riñón (SPR) se define por la presencia de hemorragia alveolar difusa y glomerulonefritis aguda rápidamente progresiva, secundarias a un proceso autoinmune. El objetivo de este estudio es presentar la primera serie peruana de SPR asociada a agentes infecciosos. Reportamos 3 casos, dos correspondieron a lupus eritematoso sistémico y uno a vasculitis asociada a poliangeítis microscópica. El primer caso se asoció a sobreinfección por C. tropicalis; el segundo caso a A. fumigatus y C. albicans; y el tercero a infestación por A. lumbricoides. Todos los casos se presentaron en mujeres, requirieron soporte ventilatorio invasivo y hemodiálisis, y dos resultaron letales. Concluimos que, el SPR es una condición clínica grave comúnmente asociada a sobreinfecciones o infestaciones, y que conlleva una elevada morbilidad y mortalidad. Puesto que no existen características clínicas específicas, resulta crucial tener un alto índice de sospecha. Las investigaciones pertinentes—pruebas inmunológicas, imagenológicas, y biopsia cutánea, renal y/o pulmonar—para precisar la etiología deben realizarse sin demora ya que el tratamiento precoz puede cambiar el pronóstico de estos pacientes.
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