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Complicações da infecção por EBV em doentes transplantados
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Orientador(es)
Resumo(s)
Paralelamente à crescente utilização de transplantes de órgão sólido ou de células estaminais no tratamento de uma miríade de doenças, tem crescido a investigação de patologias relacionadas com a imunossupressão associada. As doenças linfoproliferativas pós-transplante (PTLD, do inglês post-transplant lymphoproliferative disorders), frequentemente associadas à reactivação do vírus de Epstein-Barr nestes doentes, podem representar uma complicação grave da imunossupressão. Nesta revisão pretende-se sumarizar o mecanismo de desenvolvimento destas patologias, apresentar as classificações, enumerar os factores de risco, assim como os sinais e sintomas de apresentação de PTLD. Para orientação clínica, expõem-se ainda os exames complementares de diagnóstico úteis para o seu rastreio e monitorização, terminando por discutir os principais esquemas terapêuticos usados com intenção preventiva ou curativa, segundo as guidelines mais actuais.
The rising usage of solid organ transplants and stem cell transplant in the treatment of various diseases has been accompanied by a growing research into the consequences of the associated imunossupression. Post-Transplant Lymphoproliferative Disorders (PTLD), frequently linked to the reactivation of the Epstein-Barr virus, may represent a serious complication of immunossupression. This review summarizes the mechanism inherent to the development of these disorders, describes their current classification system, lists the risk factors and the signs and symptoms associated with PTLD. To guide the clinical approach to these disorders, this review scrutinizes the most important diagnostic tests for screening and monitoring the development of PTLD, and also discusses the main therapeutic approach to prevention or cure, according to the most recent guidelines.
The rising usage of solid organ transplants and stem cell transplant in the treatment of various diseases has been accompanied by a growing research into the consequences of the associated imunossupression. Post-Transplant Lymphoproliferative Disorders (PTLD), frequently linked to the reactivation of the Epstein-Barr virus, may represent a serious complication of immunossupression. This review summarizes the mechanism inherent to the development of these disorders, describes their current classification system, lists the risk factors and the signs and symptoms associated with PTLD. To guide the clinical approach to these disorders, this review scrutinizes the most important diagnostic tests for screening and monitoring the development of PTLD, and also discusses the main therapeutic approach to prevention or cure, according to the most recent guidelines.
Descrição
Trabalho Final do Curso de Mestrado Integrado em Medicina, Faculdade de Medicina, Universidade de Lisboa, 2016
Palavras-chave
PTLD Post-transplant lymphoproliferative disorders EBV Classification Risk factors