Inmunoglobulinas intravenosas en pacientes hospitalizados con miopatía inflamatoria idiopática
Resumen
Introducción: la inmunoglobulina intravenosa (IGIV) se ha utilizado especialmente en miopatías inflamatorias idiopáticas (MII) refractarias o graves. Objetivos: describir la prevalencia de uso y las variables asociadas con la terapia con IGIV durante la hospitalización en pacientes con MII. Materiales y métodos: se realizó un estudio retrospectivo en pacientes hospitalizados desde 2015 hasta 2023 con MII. Se describieron las variables asociadas con el uso de IGIV. Resultados: se analizaron 46 hospitalizaciones de pacientes con MII, con predominio del sexo femenino, y una edad media de 50,8 años. El fenotipo más frecuente fue dermatomiositis (76,1%); de estos, 24 pacientes (52%) recibieron tratamiento con IGIV. Este grupo presentó: mayor prevalencia de disfagia (83,3% vs. 36,4%; p<0,001), particularmente en grados moderados (29,2% vs. 9,1%) y graves (33,3% vs. 0%; p<0,001), mayor frecuencia de autoanticuerpos (70,8% vs 36,4%; p=0,04) y mayor proporción de recaídas como causa de hospitalización (54,2% vs. 22,7%; p=0,03). Aunque la mediana de creatinina fosfoquinasa fue mayor en el grupo IGIV (2030 mg/dl; RIC: 150-6955), no hubo diferencias significativas respecto del grupo control (p=0,18). La IGIV fue bien tolerada y no se registraron eventos adversos. Conclusiones: la disfagia y la recaída de la MII fueron las principales variables relacionadas con la indicación de IGIV.Citas
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