{"id":8752,"date":"2021-07-23T20:52:46","date_gmt":"2021-07-23T20:52:46","guid":{"rendered":"https:\/\/medicalcriteria.com\/web\/?p=8752"},"modified":"2025-12-30T20:47:09","modified_gmt":"2025-12-30T20:47:09","slug":"cytokine-storm","status":"publish","type":"post","link":"https:\/\/medicalcriteria.com\/web\/es\/cytokine-storm\/","title":{"rendered":"Causas Cl\u00ednicas de Tormenta de Citoquinas"},"content":{"rendered":"<div class=\"7ca9444b8380138fe077da07353677a4\" data-index=\"1\" style=\"float: none; margin:0px 0 0px 0; text-align:center;\">\n<script async src=\"https:\/\/pagead2.googlesyndication.com\/pagead\/js\/adsbygoogle.js\"><\/script>\r\n<!-- MC 2019- Horizontal -->\r\n<ins class=\"adsbygoogle\"\r\n     style=\"display:block\"\r\n     data-ad-client=\"ca-pub-0127150553352455\"\r\n     data-ad-slot=\"3806776041\"\r\n     data-ad-format=\"auto\"\r\n     data-full-width-responsive=\"true\"><\/ins>\r\n<script>\r\n     (adsbygoogle = window.adsbygoogle || []).push({});\r\n<\/script>\n<\/div>\n<p>La tormenta de citoquinas es un t\u00e9rmino general que engloba varios trastornos de la desregulaci\u00f3n inmunitaria caracterizados por s\u00edntomas constitucionales, inflamaci\u00f3n sist\u00e9mica y disfunci\u00f3n multiorg\u00e1nica que puede conducir a insuficiencia multiorg\u00e1nica si se trata de forma inadecuada.<!--more--><\/p>\n<p><strong>Causas cl\u00ednicas de tormenta de citoquinas, impulsores patol\u00f3gicos y enfoques terap\u00e9uticos*<\/strong><\/p>\n<table style=\"border-collapse: collapse; width: 100%; height: 266px;\" border=\"1\">\n<tbody>\n<tr style=\"height: 48px;\">\n<td style=\"width: 25%; height: 48px;\"><strong>Tipo de tormenta de citoquinas y desencadenante<\/strong><\/td>\n<td style=\"width: 25%; height: 48px;\"><strong>Causa<\/strong><\/td>\n<td style=\"width: 25%; height: 48px;\"><strong>Conductor patol\u00f3gico celular o de citoquinas<\/strong><\/td>\n<td style=\"width: 25%; height: 48px;\"><strong>Enfoques terap\u00e9uticos<\/strong><\/td>\n<\/tr>\n<tr style=\"height: 26px;\">\n<td style=\"width: 100%; height: 26px;\" colspan=\"4\"><strong>Iatrog\u00e9nico<\/strong><\/td>\n<\/tr>\n<tr style=\"height: 24px;\">\n<td style=\"width: 25%; height: 24px;\">Terapia de c\u00e9lulas T CAR<\/td>\n<td style=\"width: 25%; height: 24px;\">Infusi\u00f3n de c\u00e9lulas T CAR<\/td>\n<td style=\"width: 25%; height: 24px;\">Macr\u00f3fagos, c\u00e9lulas T CAR, interleuquina-6, interleuquina-1\u03b2<\/td>\n<td style=\"width: 25%; height: 24px;\">Anticuerpos anti\u2013interleuquina-6, glucocorticoides<\/td>\n<\/tr>\n<tr style=\"height: 24px;\">\n<td style=\"width: 25%; height: 24px;\">Blinatumomab<\/td>\n<td style=\"width: 25%; height: 24px;\">Infusi\u00f3n de anticuerpos que atacan el receptor de c\u00e9lulas T espec\u00edfico CD19 y CD3<\/td>\n<td style=\"width: 25%; height: 24px;\">C\u00e9lulas T activadas, macr\u00f3fagos, interleuquina-6<\/td>\n<td style=\"width: 25%; height: 24px;\">Anticuerpos anti\u2013interleuquina-6, glucocorticoides<\/td>\n<\/tr>\n<tr style=\"height: 24px;\">\n<td style=\"width: 100%; height: 24px;\" colspan=\"4\"><strong>Inducida por pat\u00f3genos<\/strong><\/td>\n<\/tr>\n<tr style=\"height: 24px;\">\n<td style=\"width: 25%; height: 24px;\">Sepsis bacteriana<\/td>\n<td style=\"width: 25%; height: 24px;\">Infecci\u00f3n bacteriana hemat\u00f3gena<\/td>\n<td style=\"width: 25%; height: 24px;\">Factores heterog\u00e9neos y multifactoriales<\/td>\n<td style=\"width: 25%; height: 24px;\">Antibi\u00f3ticos intravenosos<\/td>\n<\/tr>\n<tr style=\"height: 24px;\">\n<td style=\"width: 25%; height: 24px;\">HLH asociado a EBV<\/td>\n<td style=\"width: 25%; height: 24px;\">Infecci\u00f3n por EBV en paciente con susceptibilidad gen\u00e9tica<\/td>\n<td style=\"width: 25%; height: 24px;\">Interfer\u00f3n-\u03b3, TNF, c\u00e9lulas T CD8+<\/td>\n<td style=\"width: 25%; height: 24px;\">Terapia de depleci\u00f3n de c\u00e9lulas B, glucocorticoides<\/td>\n<\/tr>\n<tr style=\"height: 24px;\">\n<td style=\"width: 25%; height: 24px;\">MCD asociado a HHV-8<\/td>\n<td style=\"width: 25%; height: 24px;\">Infecci\u00f3n por HHV-8 en pacientes con co-infecci\u00f3n por HIV, susceptibilidad gen\u00e9tica o ambos<\/td>\n<td style=\"width: 25%; height: 24px;\">Interleuquina-6 viral, interleuquina-6<\/td>\n<td style=\"width: 25%; height: 24px;\">Terapia de depleci\u00f3n de c\u00e9lulas B<\/td>\n<\/tr>\n<tr style=\"height: 24px;\">\n<td style=\"width: 25%; height: 24px;\">Covid-19<\/td>\n<td style=\"width: 25%; height: 24px;\">Infecci\u00f3n por SARS-CoV-2, potencialmente en una persona susceptible<\/td>\n<td style=\"width: 25%; height: 24px;\">Generaci\u00f3n desconocida<\/td>\n<td style=\"width: 25%; height: 24px;\">Glucocorticoides<\/td>\n<\/tr>\n<tr style=\"height: 24px;\">\n<td style=\"width: 100%; height: 24px;\" colspan=\"4\"><strong>Monog\u00e9nica y autoinmune<\/strong><\/td>\n<\/tr>\n<tr style=\"height: 24px;\">\n<td style=\"width: 25%; height: 24px;\">HLH primario<\/td>\n<td style=\"width: 25%; height: 24px;\">Mutaci\u00f3n de la l\u00ednea germinal en genes que regulan la citotoxicidad mediada por gr\u00e1nulos<\/td>\n<td style=\"width: 25%; height: 24px;\">C\u00e9lulas T CD8 +, interfer\u00f3n-\u03b3<\/td>\n<td style=\"width: 25%; height: 24px;\">Inhibici\u00f3n o ablaci\u00f3n de c\u00e9lulas T, inhibidor de interfer\u00f3n-\u03b3, glucocorticoides<\/td>\n<\/tr>\n<tr style=\"height: 24px;\">\n<td style=\"width: 25%; height: 24px;\">HLH secundario, o MAS<\/td>\n<td style=\"width: 25%; height: 24px;\">Causa viral (EBV o CMV), trastorno autoinmunitario (artritis reumatoide o enfermedad de Still del adulto) o trastorno neopl\u00e1sico en pacientes con susceptibilidad gen\u00e9tica (linfoma)<\/td>\n<td style=\"width: 25%; height: 24px;\">C\u00e9lulas T CD8 +, interfer\u00f3n-\u03b3, interleuquina-1\u03b2, autoinflamaci\u00f3n de c\u00e9lulas mieloides<\/td>\n<td style=\"width: 25%; height: 24px;\">Tratamiento de la causa subyacente, adem\u00e1s de la inhibici\u00f3n o ablaci\u00f3n de c\u00e9lulas T, inhibidor de interleuquina-1\u03b2, inhibidores de JAK1 y JAK2, glucocorticoides<\/td>\n<\/tr>\n<tr style=\"height: 24px;\">\n<td style=\"width: 25%; height: 24px;\">Trastornos autoinflamatorios<\/td>\n<td style=\"width: 25%; height: 24px;\">Mutaciones de la l\u00ednea germinal en genes que regulan el sistema inmunol\u00f3gico innato y la activaci\u00f3n del inflamasomas<\/td>\n<td style=\"width: 25%; height: 24px;\">C\u00e9lulas innatas, TNF, interleuquina-1\u03b2<\/td>\n<td style=\"width: 25%; height: 24px;\">Anticuerpo anti-TNF, anticuerpo anti-interleuquina-1<\/td>\n<\/tr>\n<tr style=\"height: 24px;\">\n<td style=\"width: 25%; height: 24px;\">MCD idiop\u00e1tica<\/td>\n<td style=\"width: 25%; height: 24px;\">Causa desconocida<\/td>\n<td style=\"width: 25%; height: 24px;\">Interleuquina-6, linfocitos T activados, mTOR<\/td>\n<td style=\"width: 25%; height: 24px;\">Anticuerpo anti-interleuquina-6, sirolimus, ciclosporina, quimioterapia citot\u00f3xica, glucocorticoides<\/td>\n<\/tr>\n<\/tbody>\n<\/table>\n<p>*Abreviaturas: CAR denota receptor ant\u00edgeno quim\u00e9rico, CMV citomegalovirus, Covid-19 enfermedad por coronavirus 2019, EBV virus de Epstein\u2013Barr, HHV-8 herpes virus humano\u00a0 8, HIV virus de inmunodeficiencia humana, HLH linfohistiocitosis hemofagoc\u00edtica, JAK1 Janus quinasa 1, JAK2 Janus quinasa 2, MAS s\u00edndrome de activaci\u00f3n de macr\u00f3fagos, MCD enfermedad de Castleman multic\u00e9ntrica, mTOR diana de rapamicina en c\u00e9lulas de mam\u00edfero, y SARS-CoV-2 s\u00edndrome respiratorio agudo severo coronavirus 2.<\/p>\n<p>&nbsp;<\/p>\n<p>&nbsp;<\/p>\n<p><strong>Bibliograf\u00eda:<\/strong><\/p>\n<ol>\n<li>Fajgenbaum DC, June CH. Cytokine Storm. N Engl J Med. 2020 Dec 3;383(23):2255-2273. <a href=\"https:\/\/pubmed.ncbi.nlm.nih.gov\/33264547\/\" target=\"_blank\" rel=\"noopener\">[Medline]<\/a><\/li>\n<li>Canna SW, Cron RQ. Highways to hell: Mechanism-based management of cytokine storm syndromes. J Allergy Clin Immunol. 2020 Nov;146(5):949-959. <a href=\"https:\/\/pubmed.ncbi.nlm.nih.gov\/33007328\/\" target=\"_blank\" rel=\"noopener\">[Medline]<\/a><\/li>\n<\/ol>\n<p>&nbsp;<\/p>\n<p>Creado Jul 20, 2021.<\/p>\n<p>&nbsp;<\/p>\n\n<div style=\"font-size: 0px; height: 0px; line-height: 0px; margin: 0; padding: 0; clear: both;\"><\/div>","protected":false},"excerpt":{"rendered":"<p>La tormenta de citoquinas es un t\u00e9rmino general que engloba varios trastornos de la desregulaci\u00f3n inmunitaria caracterizados por s\u00edntomas constitucionales, inflamaci\u00f3n sist\u00e9mica y disfunci\u00f3n multiorg\u00e1nica que puede conducir a insuficiencia multiorg\u00e1nica si se trata de forma inadecuada.<\/p>\n","protected":false},"author":2,"featured_media":0,"comment_status":"closed","ping_status":"open","sticky":false,"template":"","format":"standard","meta":{"_lmt_disableupdate":"no","_lmt_disable":"no","_exactmetrics_skip_tracking":false,"_exactmetrics_sitenote_active":false,"_exactmetrics_sitenote_note":"","_exactmetrics_sitenote_category":0,"footnotes":""},"categories":[289],"tags":[1184,1185,2402,490,935,2401,1386,1388],"class_list":["post-8752","post","type-post","status-publish","format-standard","hentry","category-immunology","tag-causas","tag-causes","tag-citoquinas","tag-clinical","tag-clinicas","tag-cytokine","tag-storm","tag-tormenta"],"modified_by":"Guillermo Firman","_links":{"self":[{"href":"https:\/\/medicalcriteria.com\/web\/es\/wp-json\/wp\/v2\/posts\/8752","targetHints":{"allow":["GET"]}}],"collection":[{"href":"https:\/\/medicalcriteria.com\/web\/es\/wp-json\/wp\/v2\/posts"}],"about":[{"href":"https:\/\/medicalcriteria.com\/web\/es\/wp-json\/wp\/v2\/types\/post"}],"author":[{"embeddable":true,"href":"https:\/\/medicalcriteria.com\/web\/es\/wp-json\/wp\/v2\/users\/2"}],"replies":[{"embeddable":true,"href":"https:\/\/medicalcriteria.com\/web\/es\/wp-json\/wp\/v2\/comments?post=8752"}],"version-history":[{"count":11,"href":"https:\/\/medicalcriteria.com\/web\/es\/wp-json\/wp\/v2\/posts\/8752\/revisions"}],"predecessor-version":[{"id":8769,"href":"https:\/\/medicalcriteria.com\/web\/es\/wp-json\/wp\/v2\/posts\/8752\/revisions\/8769"}],"wp:attachment":[{"href":"https:\/\/medicalcriteria.com\/web\/es\/wp-json\/wp\/v2\/media?parent=8752"}],"wp:term":[{"taxonomy":"category","embeddable":true,"href":"https:\/\/medicalcriteria.com\/web\/es\/wp-json\/wp\/v2\/categories?post=8752"},{"taxonomy":"post_tag","embeddable":true,"href":"https:\/\/medicalcriteria.com\/web\/es\/wp-json\/wp\/v2\/tags?post=8752"}],"curies":[{"name":"wp","href":"https:\/\/api.w.org\/{rel}","templated":true}]}}