Leptospirosis con anemia hemolítica microangiopática. Presentación de un caso / Leptospirosis and microangiopathic hemolytic anemia. A case report
Abstract
Se presenta el caso de una mujer de 47 años de edad, color de la piel blanca, de procedencia rural y ama de casa, que ingresa en el Hospital General Docente Abel Santamaría Cuadrado de Pinar del Río por presentar fiebre elevada, artralgias y mialgias de miembros inferiores, vómitos, diarreas, astenia, anorexia marcadas y coloración ictérica azafranada de piel y mucosas. Los exámenes serológicos muestran una leptospirosis por L. autumnalis. Se comprueba la naturaleza predominantemente hemolítica del íctero, que ocasiona una anemia intensa, necesitando ser transfundida. Se analizan las posibles causas de la hemólisis. Se concluye como una anemia hemolítica microangiopática, lo que es excepcional en la enfermedad.
Palabras clave: LEPTOSPIROSIS/complicaciones, ANEMIA MICROANGIOPATICA/diagnóstico.
ABSTRACT
A 47 year-old, Caucasian housewife-woman who lives in a rural area was admitted at "Abel Santamaria Cuadrado" University Hospital presenting high fever, arthralgia and myalgia of the lower limbs, vomits and marked diarrhea, asthenia, anorexia and saffron-colored (jaundice) skin and mucosa. Serological examinations showed leptospirosis caused by Laelia autumnalis. The prevailing hemolytic nature of jaundice was proved; which provoked an intense anemia, the patient needed a blood transfusion. The possible causes of hemodialysis were analyzed. Microangiopathic hemolytic anemia is a rare complication in leptospirosis.
Key words: LEPTOSPIROSIS/complications, HEMOLYTIC ANEMIA/diagnosis.
Downloads
References
1.- García Portela R. Leptospirosis humana. Ciudad de la Habana: Editorial Científico Técnica; 2009.
2.- Bharty AR, Nally JE, Ricaldi JN, Matthias MA, Diaz MM, Lovett MA, et al. Leptospirosis: a zoonotic disease of global importance. Lancet Infect Dis. 2003; 3(12):757-71.
3.- Lenaroig Valenzuela D, Carrillo Vera M. Leptospira y disfunción, orgánica múltiple. Caso clínico y revisión de la literatura. Rev Asoc Mex Med Crit Ter Int. 2003; 17(5)176-83.
4.- Carrada Bravo T. Leptospirosis humana. Historia natural, diagnóstico y tratamiento. Rev Mex Patol. 2005; 52 (4):246-56.
5.- Public Health Division. Fact Sheet. Leptospirosis N.S.W. Public Health Bull. 2003; 14 (11-12):230.
6.- Zunino E, Pizarro R. Leptospirosis. Puesta al dia. Rev Chil Infectol. [Serie en Internet] 2007 jun [Acceso 23 feb 2009]; 24(3): [aprox. 4p.]. Disponible en: http://www.scielo.cl/scielo.php?script=sci_arttex&pid==S071610182007000300008&Ing=es.
7.- Roca Goderich R. Anemias hemolíticas. En: Reinaldo Roca Goderich. Temas de Medicina Interna. V.3. 4th ed. Ciudad de la Habana: Editorial Ciencias Médica; 2002. p. 346-350.
8.- Carvajal Gutiérrez V, Murillo O Campo N, Barrantes Boza M. Anemia hemolítica autoinmune con prueba de Coombs negativa. Revista Médica Costa Rica y Centroamérica [en Internet].2004; LXVII(552):[acceso 16 mar 2010]. Disponible en: http://www.binasss.sa.cr/revistas/rmcc/552/art8.htm.
9- Bergeson D. Autoinmune hemolitic anemias and drug induced hemolitic anemias. Inmunohematology. Principles and practice. 2nd ed. Philadelphia: Lippincott; 1998.
10.- Weatherall DJ, Ledingham JG, Warrell DA. Oxford Textbook of Medicine. New York : University Press; 1987.
11.- Jibaja E, Almeida G, Mena M, Acosta M, Acosta J, Pazmuño L. Leptospirosis: Reporte de un caso. Revista Ecuatoriana de Medicina Crítica. 2000; 1 (1):94-98.
Published
How to Cite
Issue
Section
License
Authors who have publications with this journal agree to the following terms: Authors will retain their copyrights and grant the journal the right of first publication of their work, which will be publication of their work, which will be simultaneously subject to the Creative Commons Attribution License (CC-BY-NC 4.0) that allows third parties to share the work as long as its author and first publication in this journal are indicated.
Authors may adopt other non-exclusive license agreements for distribution of the published version of the work (e.g.: deposit it in an institutional telematic archive or publish it in a volume). Likewise, and according to the recommendations of the Medical Sciences Editorial (ECIMED), authors must declare in each article their contribution according to the CRediT taxonomy (contributor roles). This taxonomy includes 14 roles, which can be used to represent the tasks typically performed by contributors in scientific academic production. It should be consulted in monograph) whenever initial publication in this journal is indicated. Authors are allowed and encouraged to disseminate their work through the Internet (e.g., in institutional telematic archives or on their web page) before and during the submission process, which may produce interesting exchanges and increase citations of the published work. (See The effect of open access). https://casrai.org/credit/