CILINDROS GRANULOSOS ORINA PDF

Universidad de Costa Rica Facultad de Microbiología Jazmín Méndez H. A Sedimento Urinario Examen general de orina: EGO Examen. Cuerpos ovales grasos o cilindros granulosos, hialinos o eritrocitarios en orina. 4 . Hematuria persistente (más de cinco eritrocitos por campo de alto poder en. Elementos que apoyan la sospecha de una hematuria de origen glomerular son la presencia simultánea de cilindros eritrocitarios, granulosos, hialinos (figuras.

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Clinical presentation, classification and treatment. Lupus nephritis LN is a major cause of morbility and mortality in patients with systemic lupus erythematosus SLE. It is important that combinations of membranous and proliferative glomerulonephritis should be reported individually in the diagnosis line, as well as the diagnosis should also include notations for any concomitant vascular or tubolointersticial lesions, therefore, one of the main advantages of this classification is that it provides a clear and unequivocal description of the various lesions and classes of lupus nephritis, allowing a better standardization and giving a basis for further clinicopathologic studies.

Otherwise, despite the development of new modalities of treatment in LN, cyclophosphamide remains the preferred initial treatment for severe forms of LN like proliferative and membranous glomerulonephritis associated with both, lesions of class III or class IV; nevertheless, the optimal treatment remains challenging because of the adverse effects associated with cyclophosphamide like sustained amenorrhea, infertility, increased susceptibility to infection, bone marrow suppression, hemorrhagic cystitis, and malignancy.

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Finally, due to these adverse effects new alternative approaches to the treatment of LN are desirable and also for some patients who fail to achieve remission with standar cytotoxic therapy and for who relapse when therapy is reduced. For refractory disease, new immunosuppressive and immunomodulating agents, immunoablative high dose of cyclophosphamide, apheresis and the biological response modifiers can be consider. Al menos uno de los siguientes debe estar presente Biopsia renal que demuestre glomerulonefritis mesangial clase IIb, proliferativa focal, proliferativa difusa o membranosa.

Cuerpos ovales grasos o cilindros granulosos, hialinos o eritrocitarios en orina. Por cada uno de los criterios mencionado se deben excluir otras causas. La raza es un factor de riesgo independiente para el desarrollo de falla renal progresiva debido a NL proliferativa difusa. En ambos centros el riesgo de enfermedad renal terminal fue significativamente mayor para los afro-americanos, a pesar del tratamiento intensivo con esteroides y pulsos de ciclofosfamida.

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Las manifestaciones renales del LES son tan variadas como las manifestaciones extrarrenales de la enfermedad. Los cilindros en orina se presentan en un tercio de los pacientes 3.

Ocasionalmente, la NL se presenta como una insuficiencia renal aguda, explicable por diferentes causas: En general, en pacientes con sospecha de NL la biopsia renal puede ser utilizada para: Estos patrones se dividen en tres grupos En este caso la biopsia puede ayudar a decidir si descontinuar o no el tratamiento.

No obstante, las recomendaciones hechas son cilindroos Esta clase se divide en: En la NL clase V, puede presentarse cualquier grado de hipercelularidad mesangial. Algunos autores han clasificado las lesiones vasculares intrarrenales de la NL en cinco grupos Nefritis mesangial clase II: El manejo establecido para la nefritis proliferativa consta de dos fases: Tabla cilindtos 70, Debido a los efectos adversos y la baja tolerancia a los esquemas que utilizan pulsos de ciclofosfamida a altas dosis, se ha estudiado la eficacia de pulsos venosos de ciclofosfamida a bajas dosis.

En otro estudio, Appel y cols. Recientemente, Ginzler y cols.

Debido a la alta toxicidad asociada con una terapia prolongada con pulsos de ciclofosfamida, se han utilizado otros inmunosupresores como la azatioprina y el MMF como terapia de mantenimiento.

En otro estudio, Chan y cols. Se han utilizado diferentes medidas para evaluar la eficacia del tratamiento inmunosupresor en NL: Anticuerpo monoclonal contra el CD40 ligando: Clinical and laboratory features of lupus nephritis.

J Am Soc Nephrol ; Clinical manifestations of lupus nephritis. Morbidity and mortality in systemic lupus erythematosus during a 5-year period.

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A multicenter prospective study of patients. Morbidity and mortality in systemic lupus erythematosus during a year period.

A comparison of early and late manifestations in a cohort of patients. Am J Med ; End-stage renal disease and systemic lupus erythematosus. Outcome of silent lupus nephritis. Semin Artritis Rheum ; Silent nephritis in systemic cilinvros erythematosus. Experience with patients in a private practice from to The revised criteria for the classification of systemic lupus erythematosus. Arthritis Oeina ; Updating the American College of Rheumatology revised criteria for the classification cilibdros systemic lupus erythematosus [letter].

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Epiemiology of systemic lupus erythematosus. Baillieres Clin Rheumatol ; Estudio de casos. Pathology of the kidney, 5th ed. Philadelphia, Lippincott-Raven, ; A study of Latin American patients. Rev Col Reumatol ; 1: Clinical and immunological factors associated with lupus nephritis in patients from northwestern Colombia. Natural History and treatment of lupus nephritis.

Semin Nephrol ; Estes D, Christian CL. The natural history ci,indros systemic lupus erythematosus by prospective analysis. Medicine Baltimore ; The delayed appearance of an antinuclear facto and the diagnosis of systemic lupus erythematosus in glomerulonephritis. Postgrad Med J ; Observations on clinical renal involvement and follow granuposos of renal function: Dutch experience with patients studied prospectively.

Ann Rheum Dis ; How to alter the course of lupus nephritis.

J Musculoskeletal Dis ; 5: Occurrence of renal tubular dysfunction in lupus nephritis. Arch Intern Med ; Q J Med ; Significance of isolated pyuria in SLE.

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Arthritis Rheum ; S abstract. Significance of isolated hematuria in SLE. A review of the current status of discoid and systemic lupus erythematosus and their variants. Acute renal failure as the initial manifestation of systemic lupus erythematosus in children. J Pediatr ; Glomerular thrombosis in systemic lupus erythematosus: Renal granklosos trombosis and inferior vena cava trombosis in systemic lupus erythematosus: How to manage patients with lupus nephritis.

Ostensen M, Villager PM. Nonsteroidal anti-inflammatory drugs in systemic lupus erythematosus. The mother in systemic lupus erythematosus. Erkan D, Sammaritano L.

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New insights into pregnancy-related complications in systemic lupus erythematosus. Curr Rheumatol Rep ; 5: Lupus nephritis and pregnancy. Pregnancy in lupus nephropaty. Acta Ostet Gynecol Scand ; Pregnancy in Lupus nephritis. Am J Kidney Dis ; Lupus nephritis in children. Systemic lupus erythematosus in childhood: Clin Immunol Immunopathol ; Platt JF, et al.

Systemic lupus erythematosus in the first two decades of life. Am J Kidney Dis ; 2 Suppl 1: Lupus nephritis in childhood and adolescence. Pediatr Nephrol ; 8: