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Resumen
En la esclerosis sistémica, se ha comunicado frecuencias de las alteraciones tiroideas (hipotiroidismo clínico y subclínico) y los anticuerpos antitiroglobulina de hasta el 43 y 73%, respectivamente, y en su patogenia participan mecanismos estructurales, autoinmunitarios y genéticos. Se debe investigar el hipotiroidismo clínico y subclínico e iniciar tratamiento con levotiroxina. La frecuencia de hiperprolactinemia en esta entidad es del 13 al 59% y los mecanismos implicados son la disfunción hipotálamica y los prolactinomas. La frecuencia de los prolactinomas es de hasta el 66%. Las frecuencias de osteopenia y osteoporosis son del 3 al 35% y del 35 al 44%, respectivamente. La osteoporosis en la esclerodermia es multifactorial (isquemia, inmovilización, síndrome de absorción intestinal deficiente, menopausia, esteroides, hiperprolactinemia, entre otros). Es importante realizar densitometría ósea en estos pacientes para identificar los casos de osteoporosis e iniciar un tratamiento oportuno.
Palabras clave:
Esclerosis sistémica
Hipotiroidismo
Hiperprolactinemia
Prolactinomas
Osteoporosis
In systemic sclerosis, the frequency of thyroid derangements (clinical and subclinical hypothyroidism) is 43 and 73% respectively; in its pathogenesis participate structural, autoimmune and genetic mechanisms. It is important to run thyroid function test and to investigate the manifestation of clinical and subclinical hypothyroidism and to initiate treatment with levothyroxine.
The frequency of hyperprolactinemia in SS goes from 13 to 59% and the implied mechanisms are the hypothalamic dysfunction and prolactinomas. The frequency of prolactinomas runs up to 66%. The frequency of osteopenia and osteoporosis is from 3 to 35 and from 35 to 44% respectively. The osteoporosis in escleroderma is multifactorial (ischemia, immobilization, intestinal malabsorption syndrome, steroids, menopause, hyperprolactinemia, among other). It is important to erform bone densitometry in these patients and to identify the cases of osteoporosis and to start opportune treatment.
Key words:
Systemic sclerosis
Hypothyroidism
Hyperprolactinemia
Prolactinomas
Osteoporosis
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