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Seguimiento a la Hemofilia adquirida en el Hospital Edgardo Rebagliati Martins de Perú
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Una tesis de grado de la Universidad Nacional Mayor de San Marcos realizó un seguimiento a la hemofilia adquirida, en el Hospital Edgardo Rebagliati Martins de Lima, Perú.
El médico cirujano a cargo, Tito Arnol Huamanyauri Mendez, tuvo como objetivo describir la epidemiología, las características clínicas, el manejo y remisión de este padecimiento en el hospital de la seguridad social de salud, utilizando una muestra de 23 pacientes diagnosticados con hemofilia adquirida entre el período agosto 2012 hasta noviembre 2022.
Se incluyó a personas mayores de 18 años, sin antecedentes personales y/o personales de este tipo de trastornos hemorrágicos y sin antecedentes de tratamiento con anticoagulantes, además de pacientes que presentaron la información completa y disponible al momento del registro.
De los pacientes con hemofilia adquirida que se les realizó seguimiento, 65.2% fueron mujeres y 34.8% hombres, con una media de edad de 62.7 con un rango de 34 a 89 años. Solo uno de ellos falleció por no recibir control con agentes de puente.
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Las condiciones encontradas por el investigador fueron un 73.9% de tipo idiopáticas y un 26.1% de no idiopáticas de los cuales el 8,7% corresponden a lupus eritematoso sistémico, puerperio (8,7%), miastenia gravis (4,3%) y artritis reumatoide (4,3%).
De la muestra, 21 pacientes presentaron predominantemente sangrado leve con equimosis y sangrado de tejidos blandos, mientras que el 2% tuvo sangrado mayor, una con metrorragia y otro con sangrado digestivo mortal.
Respecto al manejo de los pacientes, 21 de ellos recibieron terapia secuencial y se inició según la disponibilidad del agente de puente, mientras que 1 recibió Factor VII activado recombinante y el otro no recibió ningún tratamiento.
Se informa que la prevalencia de la hemofilia adquirida es de aproximadamente 1.5 casos por millón de personas por año en el mundo, de acuerdo con PubMed. Mientras que, en Perú, se estima que este padecimiento representa el 4.3% de los casos de hemofilia, según un estudio de ScienceDirect.
El Dr. Huamanyauri Mendez recomendó la creación del registro de los pacientes de hemofilia adquirida con sus características epidemiológicas y tener una base para solicitar la inclusión de estas personas en el “Documento técnico: listado de Enfermedades raras o huérfanas” del Ministerio de Salud.
Por otro lado, el profesional médico reconoció las limitaciones que se fueron presentando a lo largo del periodo del estudio, como la falta de datos nacionales y la falta de participantes que no permite evaluar correctamente la relación entre las variables o las asociaciones entre factores de exposición.
A continuación, podrá encontrar el enlace para leer toda la tesis de investigación:
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