Artritis microcristalinas

  1. Garrote Corral, S. 1
  2. Guillén Astete, C. 1
  3. Revenga Martínez, M. 2
  4. Loarce Martos, J. 1
  5. Vázquez Díaz, M. 1
  1. 1 Servicio de Reumatología. Instituto Ramón y Cajal de Investigación Sanitaria (IRYCIS). Hospital Universitario Ramón y Cajal, Madrid, España
  2. 2 Servicio de Reumatología. Instituto Ramón y Cajal de Investigación Sanitaria (IRYCIS). Hospital Universitario Ramón y Cajal, Madrid, España Departamento de Medicina y Especialidades Médicas. Universidad de Alcalá. Alcalá de Henares, Madrid, España
Revista:
Medicine: Programa de Formación Médica Continuada Acreditado

ISSN: 0304-5412

Año de publicación: 2021

Serie: 13

Número: 30

Páginas: 1702-1713

Tipo: Artículo

DOI: 10.1016/J.MED.2021.03.030 DIALNET GOOGLE SCHOLAR

Otras publicaciones en: Medicine: Programa de Formación Médica Continuada Acreditado

Resumen

Las artritis microcristalinas engloban un grupo de patologías con una misma base fisiopatológica, el depósito a nivel articular y periarticular de cristales, siendo las más frecuentes la gota y la enfermedad por depósito de cristales de pirofosfato cálcico dihidratado (PFC). La gota se origina por el depósito de cristales de urato monosódico, para lo que es necesario que existan niveles de ácido úrico elevados en sangre. En la enfermedad por depósito de cristales de PFC, el depósito se produce sobre todo en el fibrocartílago y el cartílago hialino. Pueden presentarse en forma de mono-, oligo- o poliartritis, siendo lo más frecuente al inicio la forma monoarticular. Para llevar a cabo el diagnóstico es determinante la identificación de cristales en el líquido sinovial. El tratamiento inicial consiste en abordar el brote agudo de inflamación en todos los casos, individualizando el tratamiento en función de las comorbilidades del paciente. En la gota es fundamental normalizar de forma prolongada los niveles de uricemia para reducir los depósitos previos. Para ello, además de los tratamientos clásicos hipouricemiantes, como alopurinol, tenemos otros tratamientos como febuxostat y más recientemente lesinurad. En cambio, en la enfermedad por depósito de cristales de PFC no existe actualmente ningún tratamiento eficaz para reabsorber los cristales.

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