Guía mexicana para el diagnóstico y el tratamiento de la urticaria

Désirée Larenas-Linnemann, Miguel Alejandro Medina-Ávalos, José Antonio Ortega-Martell, Angélica María Beirana-Palencia, María Isabel Rojo-Gutiérrez, Martha Alejandra Morales-Sánchez, Héctor Solorio-Gómez, María de Lourdes Alonzo-Romero Pareyón, Jorge Bernardo Vargas-Correa, Carlos Báez-Loyola, Roberto Blancas-Espinosa, Joaquín Esquer-Flores, Javier Gómez-Vera, María Graciela Guzmán-Perea, Alejandra Macías-Weinmann, César Alfonso Maldonado-García, José Darío Martínez-Villarreal, Juan José Matta-Campos, Elías Medina-Segura, Blanca Estela Del Río-Navarro, Juan Ignacio Salgado-Gama, Héctor Stone-Aguilar, Juan José Luis Sienra-Monge, Sandra Nora González-Díaz, Enrique Mendoza-López, Mario Amaya-Guerra, Alicia Lemini-López, Andrés Blanco-Montero, María Teresa Chavarría-Jiménez, Martha Graciela Guerrero-Michaus, Albina Martínez-Pérez, Ruth Ivonne Mireya Ramírez-Segura, Gabriel Montes-Narváez, Jorge Olvera-Salinas, Ana Beatriz Rosas-Sumano

Resumen


Antecedentes: la urticaria es una enfermedad que padece una quinta parte de la población en algún momento de su vida. Las guías internacionales recientes han propuesto unos cambios de fondo en su diagnóstico y tratamiento, por lo que había la necesidad de crear una guía nacional y multidisciplinaria, con base amplia en los gremios de especialistas y médicos de primer contacto en México.

Material y método: un grupo interdisciplinario de expertos clínicos y algunos expertos en metodología determinó los objetivos y alcances de la Guía de Práctica Clínica Basada en Evidencia con el instrumento SCOPE. Se decidió llevar a cabo la adaptación y transculturización de guías internacionales para el diagnóstico y tratamiento de urticaria. Con el instrumento AGREE-II se seleccionaron las tres guías de alta calidad, como guías base (Zuberbier 2014, Sánchez-Borges 2012, Powell 2007) para formular y contestar las preguntas clínicas clave, en el contexto cultural y económico mexicano, según el método de desarrollo de recomendaciones GRADE.

Resultado: mediante un proceso formal de discusión y votación durante varias juntas de expertos, se terminó la redacción de la forma final de la guía, con especial cuidado de lograr un ajuste a las realidades, valores y preferencias de los pacientes de México. Se hace hincapié en la administración de antihistamínicos vía oral de segunda generación, como tratamiento de primera elección.

Conclusión: este documento es una Guía de Práctica Clínica Basada en Evidencia para el diagnóstico y tratamiento de urticaria aguda y crónica, basada en tres guías internacionales de alta calidad. Se desarrolló por un grupo multidisciplinario. Los cuadros y algoritmos hacen a la guía amigable para su uso por médicos de primer contacto y por especialistas. 


Palabras clave


urticaria; urticaria crónica; angioedema; ronchas; habones; guía de práctica clínica; antihistamínico; corticoesteroide; ciclosporina; omalizumab

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Referencias


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DOI: http://dx.doi.org/10.29262/ram.v61i0.49

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