{"id":8004,"date":"2020-04-26T18:41:27","date_gmt":"2020-04-26T21:41:27","guid":{"rendered":"https:\/\/doctorhoogstra.com\/es\/patologia-eritropoyetica-de-protoporfiria\/"},"modified":"2020-04-30T21:33:31","modified_gmt":"2020-05-01T00:33:31","slug":"patologia-eritropoyetica-de-protoporfiria","status":"publish","type":"wiki","link":"https:\/\/doctorhoogstra.com\/fr\/wiki\/patologia-eritropoyetica-de-protoporfiria\/","title":{"rendered":"Pathologie \u00e9rythropo\u00ef\u00e9tique de la protoporphyrie"},"content":{"rendered":"<p><\/p><div id=\"ez-toc-container\" class=\"ez-toc-v2_0_88 counter-hierarchy ez-toc-counter ez-toc-grey ez-toc-container-direction\">\n<div class=\"ez-toc-title-container\">\n<p class=\"ez-toc-title\" style=\"cursor:inherit\">Contenu<\/p>\n<span class=\"ez-toc-title-toggle\"><a href=\"#\" class=\"ez-toc-pull-right ez-toc-btn ez-toc-btn-xs ez-toc-btn-default ez-toc-toggle\" aria-label=\"Basculer la table des mati\u00e8res\"><span class=\"ez-toc-js-icon-con\"><span class=\"\"><span class=\"eztoc-hide\" style=\"display:none;\">Basculer<\/span><span class=\"ez-toc-icon-toggle-span\"><svg style=\"fill: #999;color:#999\" xmlns=\"http:\/\/www.w3.org\/2000\/svg\" class=\"list-377408\" width=\"20px\" height=\"20px\" viewbox=\"0 0 24 24\" fill=\"none\"><path d=\"M6 6H4v2h2V6zm14 0H8v2h12V6zM4 11h2v2H4v-2zm16 0H8v2h12v-2zM4 16h2v2H4v-2zm16 0H8v2h12v-2z\" fill=\"currentColor\"><\/path><\/svg><svg style=\"fill: #999;color:#999\" class=\"arrow-unsorted-368013\" xmlns=\"http:\/\/www.w3.org\/2000\/svg\" width=\"10px\" height=\"10px\" viewbox=\"0 0 24 24\" version=\"1.2\" baseprofile=\"tiny\"><path d=\"M18.2 9.3l-6.2-6.3-6.2 6.3c-.2.2-.3.4-.3.7s.1.5.3.7c.2.2.4.3.7.3h11c.3 0 .5-.1.7-.3.2-.2.3-.5.3-.7s-.1-.5-.3-.7zM5.8 14.7l6.2 6.3 6.2-6.3c.2-.2.3-.5.3-.7s-.1-.5-.3-.7c-.2-.2-.4-.3-.7-.3h-11c-.3 0-.5.1-.7.3-.2.2-.3.5-.3.7s.1.5.3.7z\"\/><\/svg><\/span><\/span><\/span><\/a><\/span><\/div>\n<nav><ul class='ez-toc-list ez-toc-list-level-1 eztoc-toggle-hide-by-default' ><li class='ez-toc-page-1 ez-toc-heading-level-2'><a class=\"ez-toc-link ez-toc-heading-1\" href=\"https:\/\/doctorhoogstra.com\/fr\/wiki\/patologia-eritropoyetica-de-protoporfiria\/#Histologia-de-protoporfiria-eritropoyetica\" >Histolog\u00eda de protoporfiria eritropoy\u00e9tica<\/a><ul class='ez-toc-list-level-5' ><li class='ez-toc-heading-level-5'><ul class='ez-toc-list-level-5' ><li class='ez-toc-heading-level-5'><ul class='ez-toc-list-level-5' ><li class='ez-toc-heading-level-5'><a class=\"ez-toc-link ez-toc-heading-2\" href=\"https:\/\/doctorhoogstra.com\/fr\/wiki\/patologia-eritropoyetica-de-protoporfiria\/#Patologia-eritropoyetica-de-protoporfiria\" >Pathologie \u00e9rythropo\u00ef\u00e9tique de la protoporphyrie<\/a><\/li><\/ul><\/li><\/ul><\/li><\/ul><\/li><li class='ez-toc-page-1 ez-toc-heading-level-2'><a class=\"ez-toc-link ez-toc-heading-3\" href=\"https:\/\/doctorhoogstra.com\/fr\/wiki\/patologia-eritropoyetica-de-protoporfiria\/#Estudios-especiales-de-protoporfiria-eritropoyetica\" >Estudios especiales de protoporfiria eritropoy\u00e9tica.<\/a><\/li><li class='ez-toc-page-1 ez-toc-heading-level-2'><a class=\"ez-toc-link ez-toc-heading-4\" href=\"https:\/\/doctorhoogstra.com\/fr\/wiki\/patologia-eritropoyetica-de-protoporfiria\/#Diagnostico-diferencial-de-protoporfiria-eritropoyetica\" >Diagn\u00f3stico diferencial de protoporfiria eritropoy\u00e9tica<\/a><\/li><\/ul><\/nav><\/div>\n\n<section class=\"textBlock\">\n<p>La protoporfiria eritropoy\u00e9tica (EPP) es una condici\u00f3n metab\u00f3lica causada por la deficiencia de la ferroquelatasa <span class=\"term\" data-term-id=\"1525\">enzyme<\/span> llevando a <span class=\"term\" data-term-id=\"1684\">intracellulaire<\/span> acumulaci\u00f3n de precursores de haeme. La presentaci\u00f3n es con <span class=\"term\" data-term-id=\"349\">aigu<\/span> <span class=\"term\" data-term-id=\"706\">photosensibilit\u00e9<\/span> en la infancia dando lugar a <span class=\"term\" data-term-id=\"90\">\u00e9ryth\u00e8me<\/span> et <span class=\"term\" data-term-id=\"320\">\u00e9chelle<\/span> y eventualmente cicatrices y engrosamiento de la piel similar a la cera.<\/p>\n<h2><span class=\"ez-toc-section\" id=\"Histologia-de-protoporfiria-eritropoyetica\"><\/span>\n<span class=\"term\" data-term-id=\"128\">Histologie<\/span> de protoporfiria eritropoy\u00e9tica<span class=\"ez-toc-section-end\"><\/span><\/h2>\n<p>Dans le <span class=\"term\" data-term-id=\"61\">derme<\/span> <span class=\"term\" data-term-id=\"449\">\u00e9osinophile<\/span> <span class=\"term\" data-term-id=\"1602\">hyalin<\/span> el material se deposita en y alrededor <span class=\"term\" data-term-id=\"1068\">vaisseau sanguin<\/span> paredes los <span class=\"term\" data-term-id=\"370\">d\u00e9claration<\/span> puede ser extenso e involucrar la dermis circundante para imitar un coloide <span class=\"term\" data-term-id=\"1651\">milium<\/span> (Figuras 1,2). Se observa un engrosamiento impresionante de los vasos en un examen de mayor potencia (figura 3).<\/p>\n<p>Las ampollas subepid\u00e9rmicas similares a las observadas en la porfiria cut\u00e1nea tard\u00eda se observan en lesiones tempranas de EPP. Estas ampollas son pobres en c\u00e9lulas y <span class=\"term\" data-term-id=\"490\">inflammatoire<\/span> <span class=\"term\" data-term-id=\"541\">infiltrer<\/span> es escaso &#8220;Cuerpos de oruga&#8221;<span class=\"term\" data-term-id=\"321\">lin\u00e9aire<\/span> estructuras segmentadas compuestas de degeneraci\u00f3n <span class=\"term\" data-term-id=\"1069\">k\u00e9ratinocytes<\/span> y componentes de la membrana basal) pueden verse en el <span class=\"term\" data-term-id=\"20\"><span class=\"term\" data-term-id=\"831\">basal<\/span> casquette<\/span> <span class=\"term\" data-term-id=\"85\">\u00e9piderme<\/span> ampollas suprayacentes.<\/p>\n<section class=\"textBlock imageLinkBlockTitle\">\n<h5 class=\"colour--primary\"><span class=\"ez-toc-section\" id=\"Patologia-eritropoyetica-de-protoporfiria\"><\/span>Pathologie \u00e9rythropo\u00ef\u00e9tique de la protoporphyrie<span class=\"ez-toc-section-end\"><\/span><\/h5>\n<\/section>\n<section class=\"imageLinkBlock\">\n<div class=\"flex\">\n<div class=\"imageLinkBlock__item__image\">\n<p>                        <img alt='epp-figure-1__protectwyjqcm90zwn0il0_focusfillwzi5ncwymjisingildfd-7338055-1863794' src='https:\/\/doctorhoogstra.com\/wp-content\/uploads\/2020\/04\/epp-figure-1__ProtectWyJQcm90ZWN0Il0_FocusFillWzI5NCwyMjIsIngiLDFd-7338055.jpg'>\n<\/div>\n<p class=\"p-small\">Figure 1<\/p>\n<div class=\"imageLinkBlock__item__image\">\n<p>                        <img alt='epp-figure-2__protectwyjqcm90zwn0il0_focusfillwzi5ncwymjisingildfd-4863461-3988978' src='https:\/\/doctorhoogstra.com\/wp-content\/uploads\/2020\/04\/epp-figure-2__ProtectWyJQcm90ZWN0Il0_FocusFillWzI5NCwyMjIsIngiLDFd-4863461.jpg'>\n<\/div>\n<p class=\"p-small\">Figure 2<\/p>\n<div class=\"imageLinkBlock__item__image\">\n<p>                        <img alt='epp-figure-3__protectwyjqcm90zwn0il0_focusfillwzi5ncwymjisingildfd-2407880-9379895' src='https:\/\/doctorhoogstra.com\/wp-content\/uploads\/2020\/04\/epp-figure-3__ProtectWyJQcm90ZWN0Il0_FocusFillWzI5NCwyMjIsIngiLDFd-2407880.jpg'>\n<\/div>\n<p class=\"p-small\">figure 3<\/p>\n<div class=\"imageLinkBlock__item__image\">\n<p>                        <img alt='epp-figure-4__protectwyjqcm90zwn0il0_focusfillwzi5ncwymjisingildfd-3984612-1536682' src='https:\/\/doctorhoogstra.com\/wp-content\/uploads\/2020\/04\/epp-figure-4__ProtectWyJQcm90ZWN0Il0_FocusFillWzI5NCwyMjIsIngiLDFd-3984612.jpg'>\n<\/div>\n<p class=\"p-small\">Figure 4<\/p>\n<\/p><\/div>\n<\/section>\n<div class=\"clearfix imageLinkBlock\"><\/div>\n<h2><span class=\"ez-toc-section\" id=\"Estudios-especiales-de-protoporfiria-eritropoyetica\"><\/span>Estudios especiales de protoporfiria eritropoy\u00e9tica.<span class=\"ez-toc-section-end\"><\/span><\/h2>\n<p>El material hialino que rodea <span class=\"term\" data-term-id=\"953\">vaisseaux sanguins<\/span> es PAS positivo (figura 4) y resistente a la diastasa. Directo <span class=\"term\" data-term-id=\"142\">immunofluorescence<\/span> muestra deposici\u00f3n de <span class=\"term\" data-term-id=\"427\">immunoglobuline<\/span> (especialmente IgG), <span class=\"term\" data-term-id=\"850\">fibrine<\/span>y C3 alrededor de los vasos sangu\u00edneos en el <span class=\"term\" data-term-id=\"214\">derme papillaire<\/span>. La deposici\u00f3n del complejo de ataque de membrana (C5-9) tambi\u00e9n se ha demostrado en las paredes de los vasos. El material tambi\u00e9n se ti\u00f1e positivamente con el m\u00e9todo de hierro coloidal negro de Sud\u00e1n y Hale. Los cuerpos de oruga son positivos para PAS.<\/p>\n<div id=\"square-placement-country-holder\" class=\"country-dependent advert\">\n<div class=\"box-placement square-placement\">\n<div class=\"advert__frame\">\n<div id=\"dermnet-dermnet-mobbox\">\n<\/div><\/div><\/div><\/div>\n<h2><span class=\"ez-toc-section\" id=\"Diagnostico-diferencial-de-protoporfiria-eritropoyetica\"><\/span>\n<span class=\"term\" data-term-id=\"813\">Diagnostic diff\u00e9rentiel<\/span> de protoporfiria eritropoy\u00e9tica<span class=\"ez-toc-section-end\"><\/span><\/h2>\n<p>Porfiria cut\u00e1nea tarda: <span class=\"term\" data-term-id=\"474\">Histologique<\/span> Las apariencias son muy similares. T\u00edpicamente <span class=\"term\" data-term-id=\"753\">vasculaire<\/span> Los dep\u00f3sitos en la porfiria cut\u00e1nea tard\u00eda son menos pronunciados que el EPP y se limitan a la pared del vaso. Solar <span class=\"term\" data-term-id=\"80\">\u00e9lastose<\/span> (a menudo presente en PCT debido a la edad del paciente) no es una caracter\u00edstica de EPP.<\/p>\n<p><span class=\"term\" data-term-id=\"978\">La scl\u00e9rodermie<\/span>: Les <span class=\"term\" data-term-id=\"52\">dermique<\/span> cambios de <span class=\"term\" data-term-id=\"319\">chronique<\/span> El EPP puede parecerse a la esclerodermia; sin embargo, el <span class=\"term\" data-term-id=\"39\">collag\u00e8ne<\/span> en EPP se cree que tiene una textura m\u00e1s floja. Las ampollas y el manguito vascular no son caracter\u00edsticas de la esclerodermia.<\/p>\n<p>Proteinosis lipoidea: el manguito vascular es una caracter\u00edstica de ambas afecciones; sin embargo, en EPP, las esposas no se extienden alrededor <span class=\"term\" data-term-id=\"1827\">attach\u00e9<\/span> estructuras La correlaci\u00f3n cl\u00ednica puede ser \u00fatil.<\/p>\n<p>Milio coloide: el EPP se parece mucho al milio coloide cuando la deposici\u00f3n en la dermis papilar es extensa (figuras 1, 2). En milio coloidal, <span class=\"term\" data-term-id=\"1836\">indentations<\/span> se forma dentro del material y el engrosamiento vascular no es prominente.<\/p>\n<p><span class=\"term\" data-term-id=\"1307\">Diferenciaci\u00f3n<\/span> de otras afecciones con ampollas subepid\u00e9rmicas pobres en c\u00e9lulas (epiderm\u00f3lisis ampollosa, pseudoporfiria y <span class=\"term\" data-term-id=\"498\">bulleux<\/span> amiloidosis) se basa en caracter\u00edsticas cl\u00ednicas, estudios de inmunofluorescencia y <span class=\"term\" data-term-id=\"1430\">s\u00e9rum<\/span>, heces y orina <span class=\"term\" data-term-id=\"1514\">porphyrine<\/span> tests.<\/p>\n<\/section>","protected":false},"excerpt":{"rendered":"<p>La protoporfiria eritropoy\u00e9tica (EPP) es una condici\u00f3n metab\u00f3lica causada por la deficiencia de la ferroquelatasa enzima llevando a intracelular acumulaci\u00f3n de precursores de haeme. La presentaci\u00f3n es con agudo fotosensibilidad&#8230;<\/p>","protected":false},"author":8,"featured_media":0,"menu_order":0,"comment_status":"closed","ping_status":"closed","template":"","format":"standard","meta":{"footnotes":""},"categories":[204],"tags":[205],"class_list":["post-8004","wiki","type-wiki","status-publish","format-standard","category-glosario-definiciones","tag-patologia"],"_links":{"self":[{"href":"https:\/\/doctorhoogstra.com\/fr\/wp-json\/wp\/v2\/wiki\/8004","targetHints":{"allow":["GET"]}}],"collection":[{"href":"https:\/\/doctorhoogstra.com\/fr\/wp-json\/wp\/v2\/wiki"}],"about":[{"href":"https:\/\/doctorhoogstra.com\/fr\/wp-json\/wp\/v2\/types\/wiki"}],"author":[{"embeddable":true,"href":"https:\/\/doctorhoogstra.com\/fr\/wp-json\/wp\/v2\/users\/8"}],"replies":[{"embeddable":true,"href":"https:\/\/doctorhoogstra.com\/fr\/wp-json\/wp\/v2\/comments?post=8004"}],"version-history":[{"count":0,"href":"https:\/\/doctorhoogstra.com\/fr\/wp-json\/wp\/v2\/wiki\/8004\/revisions"}],"wp:attachment":[{"href":"https:\/\/doctorhoogstra.com\/fr\/wp-json\/wp\/v2\/media?parent=8004"}],"wp:term":[{"taxonomy":"category","embeddable":true,"href":"https:\/\/doctorhoogstra.com\/fr\/wp-json\/wp\/v2\/categories?post=8004"},{"taxonomy":"post_tag","embeddable":true,"href":"https:\/\/doctorhoogstra.com\/fr\/wp-json\/wp\/v2\/tags?post=8004"}],"curies":[{"name":"wp","href":"https:\/\/api.w.org\/{rel}","templated":true}]}}