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Gonzalez-Benavides, C. Rodriguez-Vivian, J. Ocampo-Candiani" "autores" => array:3 [ 0 => array:4 [ "nombre" => "N." "apellidos" => "Gonzalez-Benavides" "email" => array:2 [ 0 => "nery_gzz@hotmail.com" 1 => "nery.gzzb@gmail.com" ] "referencia" => array:1 [ 0 => array:2 [ "etiqueta" => "<span class="elsevierStyleSup">*</span>" "identificador" => "cor0005" ] ] ] 1 => array:2 [ "nombre" => "C." "apellidos" => "Rodriguez-Vivian" ] 2 => array:2 [ "nombre" => "J." "apellidos" => "Ocampo-Candiani" ] ] "afiliaciones" => array:1 [ 0 => array:2 [ "entidad" => "Departamento de Dermatología, Hospital Universitario Jose Eleuterio Gonzalez, Universidad Autónoma de Nuevo León, Nuevo León, México" "identificador" => "aff0005" ] ] "correspondencia" => array:1 [ 0 => array:3 [ "identificador" => "cor0005" "etiqueta" => "⁎" "correspondencia" => "Autor para correspondencia." ] ] ] ] "titulosAlternativos" => array:1 [ "en" => array:1 [ "titulo" => "Burning Erythematous Oral Macules as the Presenting Manifestation of Vitamin B<span class="elsevierStyleInf">12</span> Deficiency" ] ] "resumenGrafico" => array:2 [ "original" => 0 "multimedia" => array:6 [ "identificador" => "fig0005" "etiqueta" => "Figura 1" "tipo" => "MULTIMEDIAFIGURA" "mostrarFloat" => true "mostrarDisplay" => false "figura" => array:1 [ 0 => array:4 [ "imagen" => "gr1.jpeg" "Alto" => 1264 "Ancho" => 800 "Tamanyo" => 145304 ] ] ] ] "textoCompleto" => "<span class="elsevierStyleSections"><p id="par0005" class="elsevierStylePara elsevierViewall">Mujer de 59 años que consultó por lesiones eritematosas en lengua asociadas a dolor urente de 2 años de evolución. A la exploración se observó glositis, atrofia papilar y máculas eritematosas en el dorso y en los bordes laterales de la lengua (<a class="elsevierStyleCrossRef" href="#fig0005">fig. 1</a>a), paladar duro y mucosa oral. La histopatología mostró un infiltrado inflamatorio con eosinófilos y congestión vascular con inmunofluorescencia negativa. Seis meses después consultó de nuevo por cansancio, debilidad, parestesias en extremidades inferiores y persistencia de lesiones orales.</p><elsevierMultimedia ident="fig0005"></elsevierMultimedia><p id="par0010" class="elsevierStylePara elsevierViewall">El estudio analítico mostró anemia macrocítica con reticulocitos normales, pancitopenia, elevación de LDH y bilirrubina indirecta. La positividad de los anticuerpos anti-factor intrínseco confirmó el diagnóstico de anemia perniciosa (AP).</p><p id="par0015" class="elsevierStylePara elsevierViewall">Se indicó tratamiento con hidroxicobalamina intramuscular (1.000 μg/día durante 7 días, posteriormente 1.000 μg/semana durante 4 semanas). Al mes de tratamiento se resolvieron las lesiones orales (<a class="elsevierStyleCrossRef" href="#fig0005">fig. 1</a>b) y el hemograma estaba dentro de los parámetros normales. La paciente continuó su tratamiento con inyecciones mensuales de hidroxicobalamina.</p><p id="par0020" class="elsevierStylePara elsevierViewall">La AP es la deficiencia de cobalamina ocasionada por autoanticuerpos contra el factor intrínseco, interfiriendo en su absorción y provocando en una eritropoyesis inefectiva. Las alteraciones orales como glositis, atrofia de papilas, máculas eritematosas, queilitis angular y dolor urente en lengua preceden a los cambios hematológicos. El presente caso destaca la importancia de realizar un estudio analítico en aquellos pacientes con boca urente y lesiones cutáneas para identificar esta enfermedad.</p></span>" "pdfFichero" => "main.pdf" "tienePdf" => true "multimedia" => array:1 [ 0 => array:6 [ "identificador" => "fig0005" "etiqueta" => "Figura 1" "tipo" => "MULTIMEDIAFIGURA" "mostrarFloat" => true "mostrarDisplay" => false "figura" => array:1 [ 0 => array:4 [ "imagen" => "gr1.jpeg" "Alto" => 1264 "Ancho" => 800 "Tamanyo" => 145304 ] ] ] ] ] "idiomaDefecto" => "es" "url" => "/00017310/0000011100000004/v3_202009220625/S0001731019303035/v3_202009220625/es/main.assets" "Apartado" => array:4 [ "identificador" => "41021" "tipo" => "SECCION" "es" => array:2 [ "titulo" => "Imágenes en Dermatología" "idiomaDefecto" => true ] "idiomaDefecto" => "es" ] "PDF" => "https://static.elsevier.es/multimedia/00017310/0000011100000004/v3_202009220625/S0001731019303035/v3_202009220625/es/main.pdf?idApp=UINPBA000044&text.app=https://actasdermo.org/" "EPUB" => "https://multimedia.elsevier.es/PublicationsMultimediaV1/item/epub/S0001731019303035?idApp=UINPBA000044" ]
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