ANEURISMA AÓRTICO MEDIADO POR IGG4: PATOGÉNESIS Y ESTRATEGIA TERAPÉUTICA
DOI:
https://doi.org/10.56238/arev8n2-066Palabras clave:
Aneurisma, Aneurisma Aórtico, Aorta Abdominal, Enfermedad Relacionada con Inmunoglobulina G4Resumen
El aneurisma aórtico abdominal (AAA) es una enfermedad inflamatoria crónica multifactorial asociada a un alto riesgo de mortalidad, especialmente en casos de ruptura. La enfermedad relacionada con IgG4 (IgG4-RD) se ha implicado en la patogénesis de los aneurismas aórticos, particularmente en casos de aortitis y periaortitis, donde hay infiltración tisular por células plasmáticas IgG4+, fibrosis estoriforme y flebitis obliterante. Este estudio realizó una revisión bibliográfica integradora, con búsquedas realizadas en PubMed utilizando descriptores relacionados con IgG4 y aneurisma aórtico abdominal. Los resultados indican que la IgG4-RD afecta a grandes vasos, como la aorta, y puede conducir al desarrollo de aneurismas inflamatorios, particularmente en la región infra-abdominal. La patogénesis incluye la inflamación mediada por células inmunes innatas y adaptativas, la activación del sistema del complemento, la angiogénesis, la acción de citocinas como IL-6 y APRIL, y la formación de tejidos linfoides terciarios en la capa adventicia. La presencia de adipocitos perivasculares también contribuye al proceso inflamatorio crónico. El tratamiento se basa en glucocorticoides, eficaces en la inducción de la remisión, pero asociados a efectos adversos. En casos refractarios, se utilizan inmunosupresores o terapias biológicas, como los anticuerpos anti-CD20. Comprender el papel de la IgG4 en la patogénesis del AAA permite una mayor precisión diagnóstica y puede favorecer enfoques terapéuticos personalizados, contribuyendo a la prevención de complicaciones como la ruptura aneurismática. Se destaca la necesidad de atención clínica multidisciplinaria y actualización profesional continua ante esta condición compleja y potencialmente fatal.
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