metricas
covid
Buscar en
Revista Española de Anestesiología y Reanimación
Toda la web
Inicio Revista Española de Anestesiología y Reanimación Desprendimiento de retina exudativo bilateral en paciente con presentación atí...
Información de la revista

Estadísticas

Siga este enlace para acceder al texto completo del artículo

CASO CLÍNICO
Desprendimiento de retina exudativo bilateral en paciente con presentación atípica de preeclampsia por síndrome de HELLP
Bilateral serous retinal detachment in a patient with atypical presentation of preeclampsia due to HELLP syndrome
P. Sánchez Zamora
Autor para correspondencia
pszhso@yahoo.es

Autor para correspondencia.
, R. Alina Mejía Arnaud, R. Saz Castro, B. Gómez del Pulgar Vázquez, J. José Correa Barrera
Servicio de Anestesiología y Reanimación, Hospital Universitario Severo Ochoa, Leganés, Madrid, España
Leído
106
Veces
se ha leído el artículo
39
Total PDF
67
Total HTML
Compartir estadísticas
 array:24 [
  "pii" => "S0034935621000153"
  "issn" => "00349356"
  "doi" => "10.1016/j.redar.2020.11.015"
  "estado" => "S300"
  "fechaPublicacion" => "2022-02-01"
  "aid" => "1273"
  "copyright" => "Sociedad Española de Anestesiología, Reanimación y Terapéutica del Dolor"
  "copyrightAnyo" => "2021"
  "documento" => "simple-article"
  "crossmark" => 1
  "subdocumento" => "crp"
  "cita" => "Rev Esp Anestesiol Reanim. 2022;69:114-8"
  "abierto" => array:3 [
    "ES" => false
    "ES2" => false
    "LATM" => false
  ]
  "gratuito" => false
  "lecturas" => array:1 [
    "total" => 0
  ]
  "Traduccion" => array:1 [
    "en" => array:19 [
      "pii" => "S2341192922000269"
      "issn" => "23411929"
      "doi" => "10.1016/j.redare.2020.11.014"
      "estado" => "S300"
      "fechaPublicacion" => "2022-02-01"
      "aid" => "1273"
      "copyright" => "Sociedad Española de Anestesiología, Reanimación y Terapéutica del Dolor"
      "documento" => "simple-article"
      "crossmark" => 1
      "subdocumento" => "crp"
      "cita" => "Revista Española de Anestesiología y Reanimación (English Version). 2022;69:114-8"
      "abierto" => array:3 [
        "ES" => false
        "ES2" => false
        "LATM" => false
      ]
      "gratuito" => false
      "lecturas" => array:1 [
        "total" => 0
      ]
      "en" => array:13 [
        "idiomaDefecto" => true
        "cabecera" => "<span class="elsevierStyleTextfn">Case report</span>"
        "titulo" => "Bilateral serous retinal detachment in a patient with atypical presentation of preeclampsia due to HELLP syndrome"
        "tienePdf" => "en"
        "tieneTextoCompleto" => "en"
        "tieneResumen" => array:2 [
          0 => "en"
          1 => "es"
        ]
        "paginas" => array:1 [
          0 => array:2 [
            "paginaInicial" => "114"
            "paginaFinal" => "118"
          ]
        ]
        "titulosAlternativos" => array:1 [
          "es" => array:1 [
            "titulo" => "Desprendimiento de retina exudativo bilateral en paciente con presentaci&#243;n at&#237;pica de preeclampsia por s&#237;ndrome de HELLP"
          ]
        ]
        "contieneResumen" => array:2 [
          "en" => true
          "es" => true
        ]
        "contieneTextoCompleto" => array:1 [
          "en" => true
        ]
        "contienePdf" => array:1 [
          "en" => true
        ]
        "resumenGrafico" => array:2 [
          "original" => 0
          "multimedia" => array:8 [
            "identificador" => "fig0005"
            "etiqueta" => "Figure 1"
            "tipo" => "MULTIMEDIAFIGURA"
            "mostrarFloat" => true
            "mostrarDisplay" => false
            "figura" => array:1 [
              0 => array:4 [
                "imagen" => "gr1.jpeg"
                "Alto" => 1924
                "Ancho" => 2175
                "Tamanyo" => 332370
              ]
            ]
            "detalles" => array:1 [
              0 => array:3 [
                "identificador" => "at0005"
                "detalle" => "Figure "
                "rol" => "short"
              ]
            ]
            "descripcion" => array:1 [
              "en" => "<p id="spar0005" class="elsevierStyleSimplePara elsevierViewall">Bilateral bullous temporo-inferior serous retinal detachment with localized macular involvement&#46;</p>"
            ]
          ]
        ]
        "autores" => array:1 [
          0 => array:2 [
            "autoresLista" => "P&#46; S&#225;nchez Zamora, R&#46;A&#46; Mej&#237;a Arnaud, R&#46; Saz Castro, B&#46; G&#243;mez del Pulgar V&#225;zquez, J&#46;J&#46; Correa Barrera"
            "autores" => array:5 [
              0 => array:2 [
                "nombre" => "P&#46;"
                "apellidos" => "S&#225;nchez Zamora"
              ]
              1 => array:2 [
                "nombre" => "R&#46;A&#46;"
                "apellidos" => "Mej&#237;a Arnaud"
              ]
              2 => array:2 [
                "nombre" => "R&#46;"
                "apellidos" => "Saz Castro"
              ]
              3 => array:2 [
                "nombre" => "B&#46;"
                "apellidos" => "G&#243;mez del Pulgar V&#225;zquez"
              ]
              4 => array:2 [
                "nombre" => "J&#46;J&#46;"
                "apellidos" => "Correa Barrera"
              ]
            ]
          ]
        ]
      ]
      "idiomaDefecto" => "en"
      "Traduccion" => array:1 [
        "es" => array:9 [
          "pii" => "S0034935621000153"
          "doi" => "10.1016/j.redar.2020.11.015"
          "estado" => "S300"
          "subdocumento" => ""
          "abierto" => array:3 [
            "ES" => false
            "ES2" => false
            "LATM" => false
          ]
          "gratuito" => false
          "lecturas" => array:1 [
            "total" => 0
          ]
          "idiomaDefecto" => "es"
          "EPUB" => "https://multimedia.elsevier.es/PublicationsMultimediaV1/item/epub/S0034935621000153?idApp=UINPBA00004N"
        ]
      ]
      "EPUB" => "https://multimedia.elsevier.es/PublicationsMultimediaV1/item/epub/S2341192922000269?idApp=UINPBA00004N"
      "url" => "/23411929/0000006900000002/v1_202203120614/S2341192922000269/v1_202203120614/en/main.assets"
    ]
  ]
  "itemSiguiente" => array:19 [
    "pii" => "S0034935621000979"
    "issn" => "00349356"
    "doi" => "10.1016/j.redar.2021.01.002"
    "estado" => "S300"
    "fechaPublicacion" => "2022-02-01"
    "aid" => "1290"
    "copyright" => "Sociedad Espa&#241;ola de Anestesiolog&#237;a&#44; Reanimaci&#243;n y Terap&#233;utica del Dolor"
    "documento" => "simple-article"
    "crossmark" => 1
    "subdocumento" => "cor"
    "cita" => "Rev Esp Anestesiol Reanim. 2022;69:119-20"
    "abierto" => array:3 [
      "ES" => false
      "ES2" => false
      "LATM" => false
    ]
    "gratuito" => false
    "lecturas" => array:1 [
      "total" => 0
    ]
    "es" => array:10 [
      "idiomaDefecto" => true
      "cabecera" => "<span class="elsevierStyleTextfn">Carta al Director</span>"
      "titulo" => "Limitaciones de la medici&#243;n de temperatura en el paciente politraum&#225;tico despierto"
      "tienePdf" => "es"
      "tieneTextoCompleto" => "es"
      "paginas" => array:1 [
        0 => array:2 [
          "paginaInicial" => "119"
          "paginaFinal" => "120"
        ]
      ]
      "titulosAlternativos" => array:1 [
        "en" => array:1 [
          "titulo" => "Limitations on the temperature measurement of the awake polytraumatic patient"
        ]
      ]
      "contieneTextoCompleto" => array:1 [
        "es" => true
      ]
      "contienePdf" => array:1 [
        "es" => true
      ]
      "autores" => array:1 [
        0 => array:2 [
          "autoresLista" => "R&#46; Blasco Mari&#241;o, I&#46; Soteras Mart&#237;nez"
          "autores" => array:2 [
            0 => array:2 [
              "nombre" => "R&#46;"
              "apellidos" => "Blasco Mari&#241;o"
            ]
            1 => array:2 [
              "nombre" => "I&#46;"
              "apellidos" => "Soteras Mart&#237;nez"
            ]
          ]
        ]
      ]
    ]
    "idiomaDefecto" => "es"
    "Traduccion" => array:1 [
      "en" => array:9 [
        "pii" => "S234119292200035X"
        "doi" => "10.1016/j.redare.2021.01.005"
        "estado" => "S300"
        "subdocumento" => ""
        "abierto" => array:3 [
          "ES" => false
          "ES2" => false
          "LATM" => false
        ]
        "gratuito" => false
        "lecturas" => array:1 [
          "total" => 0
        ]
        "idiomaDefecto" => "en"
        "EPUB" => "https://multimedia.elsevier.es/PublicationsMultimediaV1/item/epub/S234119292200035X?idApp=UINPBA00004N"
      ]
    ]
    "EPUB" => "https://multimedia.elsevier.es/PublicationsMultimediaV1/item/epub/S0034935621000979?idApp=UINPBA00004N"
    "url" => "/00349356/0000006900000002/v1_202201260835/S0034935621000979/v1_202201260835/es/main.assets"
  ]
  "itemAnterior" => array:19 [
    "pii" => "S0034935620302942"
    "issn" => "00349356"
    "doi" => "10.1016/j.redar.2020.10.014"
    "estado" => "S300"
    "fechaPublicacion" => "2022-02-01"
    "aid" => "1253"
    "copyright" => "Sociedad Espa&#241;ola de Anestesiolog&#237;a&#44; Reanimaci&#243;n y Terap&#233;utica del Dolor"
    "documento" => "simple-article"
    "crossmark" => 1
    "subdocumento" => "crp"
    "cita" => "Rev Esp Anestesiol Reanim. 2022;69:109-13"
    "abierto" => array:3 [
      "ES" => false
      "ES2" => false
      "LATM" => false
    ]
    "gratuito" => false
    "lecturas" => array:1 [
      "total" => 0
    ]
    "es" => array:13 [
      "idiomaDefecto" => true
      "cabecera" => "<span class="elsevierStyleTextfn">Caso cl&#237;nico</span>"
      "titulo" => "Manejo anest&#233;sico en neurocirug&#237;a de paciente con s&#237;ndrome de Eisenmenger y s&#237;ndrome de Down&#46; Reporte de un caso"
      "tienePdf" => "es"
      "tieneTextoCompleto" => "es"
      "tieneResumen" => array:2 [
        0 => "es"
        1 => "en"
      ]
      "paginas" => array:1 [
        0 => array:2 [
          "paginaInicial" => "109"
          "paginaFinal" => "113"
        ]
      ]
      "titulosAlternativos" => array:1 [
        "en" => array:1 [
          "titulo" => "Anaesthetic management in neurosurgery in a patient with Eisenmenger syndrome and Down syndrome&#46; A case report"
        ]
      ]
      "contieneResumen" => array:2 [
        "es" => true
        "en" => true
      ]
      "contieneTextoCompleto" => array:1 [
        "es" => true
      ]
      "contienePdf" => array:1 [
        "es" => true
      ]
      "resumenGrafico" => array:2 [
        "original" => 0
        "multimedia" => array:7 [
          "identificador" => "fig0010"
          "etiqueta" => "Figura 2"
          "tipo" => "MULTIMEDIAFIGURA"
          "mostrarFloat" => true
          "mostrarDisplay" => false
          "figura" => array:1 [
            0 => array:4 [
              "imagen" => "gr2.jpeg"
              "Alto" => 1397
              "Ancho" => 1750
              "Tamanyo" => 178518
            ]
          ]
          "descripcion" => array:1 [
            "es" => "<p id="spar0020" class="elsevierStyleSimplePara elsevierViewall">Imagen ecocardiogr&#225;fica transtor&#225;cica&#46; Se observa gran defecto septal con shunt derecha-izquierda propio del s&#237;ndrome de Eisenmenger&#46;</p>"
          ]
        ]
      ]
      "autores" => array:1 [
        0 => array:2 [
          "autoresLista" => "J&#46;M&#46; G&#243;mez Tarradas, A&#46; Calvo, I&#46; Belda, T&#46; Topczewski, F&#46;J&#46; Tercero, R&#46; Valero"
          "autores" => array:6 [
            0 => array:2 [
              "nombre" => "J&#46;M&#46;"
              "apellidos" => "G&#243;mez Tarradas"
            ]
            1 => array:2 [
              "nombre" => "A&#46;"
              "apellidos" => "Calvo"
            ]
            2 => array:2 [
              "nombre" => "I&#46;"
              "apellidos" => "Belda"
            ]
            3 => array:2 [
              "nombre" => "T&#46;"
              "apellidos" => "Topczewski"
            ]
            4 => array:2 [
              "nombre" => "F&#46;J&#46;"
              "apellidos" => "Tercero"
            ]
            5 => array:2 [
              "nombre" => "R&#46;"
              "apellidos" => "Valero"
            ]
          ]
        ]
      ]
    ]
    "idiomaDefecto" => "es"
    "Traduccion" => array:1 [
      "en" => array:9 [
        "pii" => "S2341192922000221"
        "doi" => "10.1016/j.redare.2020.10.014"
        "estado" => "S300"
        "subdocumento" => ""
        "abierto" => array:3 [
          "ES" => false
          "ES2" => false
          "LATM" => false
        ]
        "gratuito" => false
        "lecturas" => array:1 [
          "total" => 0
        ]
        "idiomaDefecto" => "en"
        "EPUB" => "https://multimedia.elsevier.es/PublicationsMultimediaV1/item/epub/S2341192922000221?idApp=UINPBA00004N"
      ]
    ]
    "EPUB" => "https://multimedia.elsevier.es/PublicationsMultimediaV1/item/epub/S0034935620302942?idApp=UINPBA00004N"
    "url" => "/00349356/0000006900000002/v1_202201260835/S0034935620302942/v1_202201260835/es/main.assets"
  ]
  "es" => array:19 [
    "idiomaDefecto" => true
    "cabecera" => "<span class="elsevierStyleTextfn">CASO CL&#205;NICO</span>"
    "titulo" => "Desprendimiento de retina exudativo bilateral en paciente con presentaci&#243;n at&#237;pica de preeclampsia por s&#237;ndrome de HELLP"
    "tieneTextoCompleto" => true
    "paginas" => array:1 [
      0 => array:2 [
        "paginaInicial" => "114"
        "paginaFinal" => "118"
      ]
    ]
    "autores" => array:1 [
      0 => array:4 [
        "autoresLista" => "P&#46; S&#225;nchez Zamora, R&#46; Alina Mej&#237;a Arnaud, R&#46; Saz Castro, B&#46; G&#243;mez del Pulgar V&#225;zquez, J&#46; Jos&#233; Correa Barrera"
        "autores" => array:5 [
          0 => array:4 [
            "nombre" => "P&#46;"
            "apellidos" => "S&#225;nchez Zamora"
            "email" => array:1 [
              0 => "pszhso@yahoo.es"
            ]
            "referencia" => array:1 [
              0 => array:2 [
                "etiqueta" => "<span class="elsevierStyleSup">&#42;</span>"
                "identificador" => "cor0005"
              ]
            ]
          ]
          1 => array:2 [
            "nombre" => "R&#46;"
            "apellidos" => "Alina Mej&#237;a Arnaud"
          ]
          2 => array:2 [
            "nombre" => "R&#46;"
            "apellidos" => "Saz Castro"
          ]
          3 => array:2 [
            "nombre" => "B&#46;"
            "apellidos" => "G&#243;mez del Pulgar V&#225;zquez"
          ]
          4 => array:2 [
            "nombre" => "J&#46;"
            "apellidos" => "Jos&#233; Correa Barrera"
          ]
        ]
        "afiliaciones" => array:1 [
          0 => array:2 [
            "entidad" => "Servicio de Anestesiolog&#237;a y Reanimaci&#243;n&#44; Hospital Universitario Severo Ochoa&#44; Legan&#233;s&#44; Madrid&#44; Espa&#241;a"
            "identificador" => "aff0005"
          ]
        ]
        "correspondencia" => array:1 [
          0 => array:3 [
            "identificador" => "cor0005"
            "etiqueta" => "&#8270;"
            "correspondencia" => "Autor para correspondencia&#46;"
          ]
        ]
      ]
    ]
    "titulosAlternativos" => array:1 [
      "en" => array:1 [
        "titulo" => "Bilateral serous retinal detachment in a patient with atypical presentation of preeclampsia due to HELLP syndrome"
      ]
    ]
    "resumenGrafico" => array:2 [
      "original" => 0
      "multimedia" => array:7 [
        "identificador" => "fig0005"
        "etiqueta" => "Figura 1"
        "tipo" => "MULTIMEDIAFIGURA"
        "mostrarFloat" => true
        "mostrarDisplay" => false
        "figura" => array:1 [
          0 => array:4 [
            "imagen" => "gr1.jpeg"
            "Alto" => 1924
            "Ancho" => 2175
            "Tamanyo" => 332370
          ]
        ]
        "descripcion" => array:1 [
          "es" => "<p id="spar0055" class="elsevierStyleSimplePara elsevierViewall">Desprendimiento de retina exudativo temporo-inferior bulloso con afectaci&#243;n macular localizado en ambos ojos&#46;</p>"
        ]
      ]
    ]
    "textoCompleto" => "<span class="elsevierStyleSections"><span id="sec0005" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="sect0025">Introducci&#243;n</span><p id="par0005" class="elsevierStylePara elsevierViewall">La preeclampsia es un desorden hipertensivo sist&#233;mico definido como la aparici&#243;n de hipertensi&#243;n arterial &#40;HTA&#41; y proteinuria tras la 20&#46;&#170; semana de gestaci&#243;n hasta el posparto<a class="elsevierStyleCrossRefs" href="#bib0055"><span class="elsevierStyleSup">1&#8211;3</span></a>&#44; la ausencia de proteinuria o HTA se consideran variantes at&#237;picas de preeclampsia<a class="elsevierStyleCrossRef" href="#bib0055"><span class="elsevierStyleSup">1</span></a>&#46;</p><p id="par0010" class="elsevierStylePara elsevierViewall">Aunque la HTA y la proteinuria se reconocen como criterios esenciales para el diagn&#243;stico de preeclampsia&#44; esta enfermedad multisist&#233;mica tambi&#233;n puede presentarse con manifestaciones at&#237;picas que cursan sin HTA o proteinuria como en el s&#237;ndrome de HELLP&#46;</p><p id="par0015" class="elsevierStylePara elsevierViewall">El s&#237;ndrome de HELLP representa una forma severa de preeclampsia&#44; con una incidencia del 10-15&#37; de las mismas<a class="elsevierStyleCrossRef" href="#bib0060"><span class="elsevierStyleSup">2</span></a>&#46; Este incluye trombocitopenia &#40;&#60;150&#46;000 plaquetas&#47;mcl&#41;&#44; hem&#243;lisis y disfunci&#243;n hep&#225;tica con elevaci&#243;n de transaminasas y LDH<a class="elsevierStyleCrossRefs" href="#bib0060"><span class="elsevierStyleSup">2&#8211;6</span></a>&#46;</p><p id="par0020" class="elsevierStylePara elsevierViewall">En un 25-100&#37; de preeclampsias se presentan cambios en la vascularizaci&#243;n de la retina&#44; en relaci&#243;n con el desarrollo de retinopat&#237;a hipertensiva por vasoconstricci&#243;n de las arteriolas retinianas<a class="elsevierStyleCrossRefs" href="#bib0070"><span class="elsevierStyleSup">4&#44;6</span></a>&#46; Sin embargo&#44; la sintomatolog&#237;a visual solo ocurre en el 25&#37; de preeclampsias y 50&#37; de eclampsias&#44; por disfunci&#243;n en la circulaci&#243;n de la retina y la coroides<a class="elsevierStyleCrossRefs" href="#bib0060"><span class="elsevierStyleSup">2&#44;3&#44;5&#44;7</span></a>&#46;</p><p id="par0025" class="elsevierStylePara elsevierViewall">El desprendimiento de retina exudativo &#40;DRE&#41; es una rara complicaci&#243;n que afecta al 1&#37; de preeclampsias<a class="elsevierStyleCrossRefs" href="#bib0055"><span class="elsevierStyleSup">1&#8211;9</span></a>&#44; con una incidencia que aumenta hasta siete veces cuando la preeclampsia est&#225; asociada con el s&#237;ndrome de HELLP<a class="elsevierStyleCrossRefs" href="#bib0060"><span class="elsevierStyleSup">2&#44;5</span></a>&#46; Aunque la mayor&#237;a de los DRE est&#225;n relacionados con signos de retinopat&#237;a hipertensiva<a class="elsevierStyleCrossRef" href="#bib0090"><span class="elsevierStyleSup">8</span></a>&#44; existen casos de DRE en gestantes normotensas<a class="elsevierStyleCrossRefs" href="#bib0055"><span class="elsevierStyleSup">1&#44;4</span></a>&#44; por lo que la HTA no explicar&#237;a completamente la etiopatogenia de este fen&#243;meno&#46;</p><p id="par0030" class="elsevierStylePara elsevierViewall">Se describe el caso de un DRE tras una ces&#225;rea en una gestante con preeclampsia at&#237;pica por s&#237;ndrome de HELLP que curs&#243; con normotensi&#243;n&#46; La singularidad del caso fue la aparici&#243;n del DRE anticipando la gravedad en la evoluci&#243;n cl&#237;nica hacia un s&#237;ndrome de HELLP&#46;</p></span><span id="sec0010" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="sect0030">Caso cl&#237;nico</span><p id="par0035" class="elsevierStylePara elsevierViewall">Primigesta de 37 a&#241;os con gestaci&#243;n mediante fecundaci&#243;n in vitro&#46; Acude en la 34&#46;&#170; semana por rotura prematura de membranas&#46; Al ingreso presentaba TA de 118&#47;85<span class="elsevierStyleHsp" style=""></span>mmHg y destacaba proteinuria con creatinina 1&#44;46<span class="elsevierStyleHsp" style=""></span>mg&#47;dl &#40;<a class="elsevierStyleCrossRef" href="#tbl0005">tabla 1</a>&#41;&#46;</p><elsevierMultimedia ident="tbl0005"></elsevierMultimedia><p id="par0040" class="elsevierStylePara elsevierViewall">A pesar de la normotensi&#243;n&#44; la presencia de proteinuria inclin&#243; el diagn&#243;stico hacia una variante at&#237;pica de preeclampsia&#46; Se inici&#243; tratamiento con corticoides para maduraci&#243;n fetal&#44; perfusi&#243;n de sulfato de magnesio &#40;S0<span class="elsevierStyleInf">4</span>Mg&#41; y control estricto de TA y diuresis&#46; Se procedi&#243; a inducci&#243;n del parto&#44; requiriendo analgesia epidural durante el trabajo de parto&#46; Tras 8<span class="elsevierStyleHsp" style=""></span>h de inducci&#243;n se indic&#243; una ces&#225;rea urgente&#44; por p&#233;rdida de bienestar fetal&#44; realiz&#225;ndose con refuerzo anest&#233;sico por cat&#233;ter epidural&#44; sin sangrado rese&#241;able y permaneciendo la paciente estable durante el procedimiento&#46;</p><p id="par0045" class="elsevierStylePara elsevierViewall">A su ingreso en reanimaci&#243;n la paciente comenz&#243; con disminuci&#243;n de la agudeza visual &#40;AV&#41; y visi&#243;n borrosa&#46; En las siguientes h y de forma progresiva&#44; en la anal&#237;tica se apreciaba la aparici&#243;n de trombocitopenia&#44; elevaci&#243;n de LDH y de AST&#47;ALT &#40;<a class="elsevierStyleCrossRef" href="#tbl0005">tabla 1</a>&#41;&#44; todo ello compatible con el desarrollo de un s&#237;ndrome de HELLP&#46;</p><p id="par0050" class="elsevierStylePara elsevierViewall">Tras consultar con oftalmolog&#237;a&#44; se indic&#243; una TAC cerebral que descart&#243; signos de ceguera cortical y se realiz&#243; un fondo de ojo&#44; donde se observ&#243; un DR exudativo temporo-inferior bulloso con afectaci&#243;n macular en ambos ojos &#40;<a class="elsevierStyleCrossRef" href="#fig0005">fig&#46; 1</a>&#41;&#46;</p><elsevierMultimedia ident="fig0005"></elsevierMultimedia><p id="par0055" class="elsevierStylePara elsevierViewall">En reanimaci&#243;n continu&#243; tratamiento con S0<span class="elsevierStyleInf">4</span>Mg&#44; manteniendo normotensi&#243;n y presentando un deterioro de la funci&#243;n renal posparto que se optimiz&#243; con fluidoterapia m&#225;s diur&#233;ticos&#46;</p><p id="par0060" class="elsevierStylePara elsevierViewall">A las 72<span class="elsevierStyleHsp" style=""></span>h posparto la paciente presentaba mejor&#237;a en la funci&#243;n renal y de los par&#225;metros anal&#237;ticos &#40;<a class="elsevierStyleCrossRef" href="#tbl0005">tabla 1</a>&#41;&#46; Se traslad&#243; a planta tras 5 d&#237;as en reanimaci&#243;n&#44; estable y con una recuperaci&#243;n de la AV de 0&#44;4&#47;1 en ambos ojos&#46;</p><p id="par0065" class="elsevierStylePara elsevierViewall">A los 15 d&#237;as del DRE&#44; la exploraci&#243;n de la AV era 0&#44;7&#47;1 bilateral con resoluci&#243;n parcial del DRE&#46;</p><p id="par0070" class="elsevierStylePara elsevierViewall">De forma ambulatoria&#44; a las 4 semanas&#44; la revisi&#243;n por oftalmolog&#237;a mostraba una recuperaci&#243;n total de la visi&#243;n con una AV de 1&#47;1 bilateral sin secuelas&#46;</p></span><span id="sec0015" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="sect0035">Discusi&#243;n</span><p id="par0075" class="elsevierStylePara elsevierViewall">La preeclampsia es un desorden hipertensivo del embarazo que cursa con HTA &#40;&#8805;140&#47;90<span class="elsevierStyleHsp" style=""></span>mmHg&#41; y proteinuria &#40;&#8805; 0&#44;3<span class="elsevierStyleHsp" style=""></span>g&#47;24<span class="elsevierStyleHsp" style=""></span>h&#41; y que aparece tras la 20&#46;&#170; semana de embarazo hasta el posparto<a class="elsevierStyleCrossRefs" href="#bib0055"><span class="elsevierStyleSup">1&#44;3</span></a>&#46; Un 10-15&#37; de preeclampsias se complican con un s&#237;ndrome de HELLP &#40;trombocitopenia&#44; hem&#243;lisis y elevaci&#243;n de enzimas hep&#225;ticas&#41; que generalmente se desarrolla en el 3&#46;<span class="elsevierStyleSup">er</span> trimestre o en el posparto<a class="elsevierStyleCrossRef" href="#bib0065"><span class="elsevierStyleSup">3</span></a>&#46; El s&#237;ndrome de HELLP es considerado una variante de preeclampsia grave&#44; y no siempre cumple con los criterios de diagn&#243;stico convencionales de HTA o proteinuria&#46;</p><p id="par0080" class="elsevierStylePara elsevierViewall">Asociadas a la preeclampsia se han descrito distintas alteraciones visuales que incluyen&#58; la visi&#243;n borrosa&#44; las fotopsias&#44; el edema de retina&#44; las hemorragias retinianas o v&#237;treas&#44; la retinopat&#237;a de Purtscher-like&#44; la oclusi&#243;n de la vena central de la retina&#44; el DRE o la ceguera cortical<a class="elsevierStyleCrossRefs" href="#bib0065"><span class="elsevierStyleSup">3&#44;9</span></a>&#46; La visi&#243;n borrosa y la p&#233;rdida de AV son los s&#237;ntomas m&#225;s comunes encontrados&#46; La presencia de un DRE constituye una forma severa de preeclampsia<a class="elsevierStyleCrossRef" href="#bib0055"><span class="elsevierStyleSup">1</span></a>&#46;</p><p id="par0085" class="elsevierStylePara elsevierViewall">La p&#233;rdida aguda de visi&#243;n por un DRE es una rara complicaci&#243;n que ocurre en un 1&#37; de preeclampsias severas<a class="elsevierStyleCrossRefs" href="#bib0055"><span class="elsevierStyleSup">1&#8211;9</span></a> y un 10&#37; de eclampsias<a class="elsevierStyleCrossRefs" href="#bib0060"><span class="elsevierStyleSup">2&#44;6&#44;9</span></a>&#46; La probabilidad de presentar un DRE en la preeclampsia aumenta hasta siete veces cuando esta se asocia al s&#237;ndrome de HELLP&#44; siendo este un factor favorecedor de DRE en gestantes con preeclampsia<a class="elsevierStyleCrossRef" href="#bib0060"><span class="elsevierStyleSup">2</span></a>&#46;</p><p id="par0090" class="elsevierStylePara elsevierViewall">Debido a los efectos teratog&#233;nicos de la fluoresce&#237;na en el desarrollo fetal&#44; los estudios que intentan explicar la fisiopatolog&#237;a del DRE en la preeclampsia son limitados&#46; No obstante&#44; la isquemia coroidal por vasoconstricci&#243;n arteriolar se propone como el principal mecanismo fisiopatol&#243;gico&#46; La isquemia del epitelio pigmentario retiniano degradar&#237;a la barrera retiniana&#44; favoreciendo el paso de un exudado seroso al espacio subretiniano que producir&#237;a el desprendimiento en la retina<a class="elsevierStyleCrossRefs" href="#bib0055"><span class="elsevierStyleSup">1&#8211;8</span></a>&#46;</p><p id="par0095" class="elsevierStylePara elsevierViewall">Otro mecanismo patog&#233;nico descrito es la hem&#243;lisis&#44; presente en el s&#237;ndrome de HELLP&#44; con obstrucci&#243;n en los capilares coroideos e isquemia coroidal<a class="elsevierStyleCrossRefs" href="#bib0060"><span class="elsevierStyleSup">2&#44;5</span></a>&#46; Sin embargo&#44; otros autores<a class="elsevierStyleCrossRefs" href="#bib0080"><span class="elsevierStyleSup">6&#44;8</span></a> han implicado a la tromboplastina placentaria en la preeclampsia que&#44; por activaci&#243;n de una coagulaci&#243;n intravascular diseminada&#44; provocar&#237;an isquemia coroidea y un DRE&#46;</p><p id="par0100" class="elsevierStylePara elsevierViewall">Hussain et al&#46;<a class="elsevierStyleCrossRef" href="#bib0060"><span class="elsevierStyleSup">2</span></a>&#44; en su revisi&#243;n de 43 casos documentados de desprendimiento de retina&#44; entre un total de 97 mujeres diagnosticadas de preeclampsia&#44; encuentra que solo una de ellas presentaba normotensi&#243;n&#46; De la misma forma&#44; Singh et al&#46;<a class="elsevierStyleCrossRef" href="#bib0070"><span class="elsevierStyleSup">4</span></a>&#44; y Tranos et al&#46;<a class="elsevierStyleCrossRef" href="#bib0090"><span class="elsevierStyleSup">8</span></a>&#44; presentan un DRE en gestantes con s&#237;ndrome de HELLP sin retinopat&#237;a hipertensiva&#46; En nuestro caso cl&#237;nico&#44; al igual que describen estos autores&#44; la paciente no desarroll&#243; ni hipertensi&#243;n ni retinopat&#237;a hipertensiva&#46;</p><p id="par0105" class="elsevierStylePara elsevierViewall">Aunque la mayor&#237;a de los DRE desarrollan signos de retinopat&#237;a hipertensiva<a class="elsevierStyleCrossRef" href="#bib0070"><span class="elsevierStyleSup">4</span></a>&#44; esta no est&#225; presente en todos los casos&#46; Para comprender las causas de la aparici&#243;n de un DRE en pacientes normotensas&#44; se han implicado la coexistencia de otros mecanismos como la hem&#243;lisis microangiop&#225;tica o la hipercoagulabilidad&#46; Estos ser&#237;an los responsables de la isquemia coroidal y&#44; explicar&#237;a por qu&#233; la retinopat&#237;a hipertensiva&#44; en s&#237; misma&#44; no es el &#250;nico factor determinante del DRE en la preeclampsia y la mayor incidencia de DRE en gestantes con s&#237;ndrome de HELLP&#46;</p><p id="par0110" class="elsevierStylePara elsevierViewall">La incidencia real del DRE en la preeclampsia y s&#237;ndrome de HELLP es incierta y establecida a trav&#233;s de revisiones de casos cl&#237;nicos&#46; Se describe con mayor frecuencia en prim&#237;paras &#40;60&#37;&#41;&#44; con presentaci&#243;n ocular bilateral &#40;89&#37;&#41;&#44; m&#225;s com&#250;n en el posparto &#40;69&#37;&#41; y si se realiz&#243; una ces&#225;rea como m&#233;todo para finalizar el parto &#40;76&#37;&#41;<a class="elsevierStyleCrossRef" href="#bib0060"><span class="elsevierStyleSup">2</span></a>&#46; En general&#44; el DRE se asocia a un mayor n&#250;mero de ces&#225;reas<a class="elsevierStyleCrossRefs" href="#bib0060"><span class="elsevierStyleSup">2&#44;6</span></a>&#44; aunque su aparici&#243;n no constituye una contraindicaci&#243;n de parto vaginal<a class="elsevierStyleCrossRef" href="#bib0085"><span class="elsevierStyleSup">7</span></a>&#46;</p><p id="par0115" class="elsevierStylePara elsevierViewall">Los DRE con presentaci&#243;n preparto se han relacionado con mayor gravedad&#44; ya que las alteraciones en la microcirculaci&#243;n de la retina se correlacionan con las de la placenta&#44; siendo un marcador &#250;til de bienestar fetal<a class="elsevierStyleCrossRef" href="#bib0070"><span class="elsevierStyleSup">4</span></a>&#46; La presencia de DRE o papiledema es un indicador de finalizaci&#243;n del parto&#44; con el fin de preservar la visi&#243;n en la paciente<a class="elsevierStyleCrossRef" href="#bib0070"><span class="elsevierStyleSup">4</span></a>&#46;</p><p id="par0120" class="elsevierStylePara elsevierViewall">La singularidad del caso cl&#237;nico presentado fue su aparici&#243;n en el puerperio inmediato&#44; de forma anticipatoria al resto de manifestaciones cl&#237;nicas de un s&#237;ndrome de HELLP at&#237;pico que curs&#243; con normotensi&#243;n&#46; En el caso expuesto&#44; la ces&#225;rea se realiz&#243; por p&#233;rdida de bienestar fetal&#46; La paciente no present&#243; HTA ni pre- ni posparto&#44; pero s&#237; una p&#233;rdida de AV previa a la trombocitopenia y a la elevaci&#243;n de transaminasas y de la LDH&#46;</p><p id="par0125" class="elsevierStylePara elsevierViewall">En el diagn&#243;stico diferencial se descart&#243; la p&#250;rpura trobocitop&#233;nica tromb&#243;tica y el s&#237;ndrome ur&#233;mico hemol&#237;tico at&#237;pico asociado al embarazo en favor del s&#237;ndrome de HELLP&#44; por las alteraciones anal&#237;ticas compatibles y por la mejor&#237;a de la funci&#243;n renal tras la resoluci&#243;n del parto<a class="elsevierStyleCrossRef" href="#bib0100"><span class="elsevierStyleSup">10</span></a> &#40;<a class="elsevierStyleCrossRef" href="#tbl0010">tabla 2</a>&#41;&#46;</p><elsevierMultimedia ident="tbl0010"></elsevierMultimedia><p id="par0130" class="elsevierStylePara elsevierViewall">El tratamiento del DRE es conservador&#44; sin precisar cirug&#237;a&#46; Generalmente presenta un pron&#243;stico favorable con una recuperaci&#243;n total de la visi&#243;n entre 2-12 semanas tras la resoluci&#243;n del parto<a class="elsevierStyleCrossRefs" href="#bib0060"><span class="elsevierStyleSup">2&#44;6</span></a>&#46; Este revertir&#225; las manifestaciones oculares evitando secuelas visuales&#46;</p><p id="par0135" class="elsevierStylePara elsevierViewall">La buena evoluci&#243;n del DRE hace que muchos pasen infradiagnosticados&#44; o por su escasa sintomatolog&#237;a o por su resoluci&#243;n tras el parto&#46; Sin embargo&#44; y a pesar del buen pron&#243;stico&#44; tambi&#233;n se han descrito cambios en el epitelio pigmentario macular de la retina&#44; con &#225;reas de infarto coriocapilar o &#171;manchas de Elschnig&#187;&#46;&#160;Estos cambios pueden imitar una distrofia macular o una degeneraci&#243;n de la retina y&#44; aunque con poca frecuencia&#44; s&#237; pueden provocar una discapacidad visual permanente<a class="elsevierStyleCrossRef" href="#bib0090"><span class="elsevierStyleSup">8</span></a>&#46; La importancia de un reconocimiento precoz del DRE mejorar&#225; el pron&#243;stico&#46;</p><p id="par0140" class="elsevierStylePara elsevierViewall">En la bibliograf&#237;a revisada&#44; muchos autores<a class="elsevierStyleCrossRefs" href="#bib0060"><span class="elsevierStyleSup">2&#44;5&#44;9</span></a> coinciden en la recomendaci&#243;n de realizar a toda gestante con preeclampsia o s&#237;ndrome de HELLP&#44; incluso en asintom&#225;ticas&#44; una exploraci&#243;n oftalmol&#243;gica sistem&#225;tica&#46;</p></span><span id="sec0020" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="sect0040">Conclusiones</span><p id="par0145" class="elsevierStylePara elsevierViewall">El DRE es una rara complicaci&#243;n en pacientes con preeclampsia severa&#44; presentando una mayor incidencia si esta se acompa&#241;a de s&#237;ndrome de HELLP&#46;</p><p id="par0150" class="elsevierStylePara elsevierViewall">La etiopatogenia del DRE asociado a s&#237;ndrome de HELLP parece estar fuertemente relacionado con la hem&#243;lisis microangiop&#225;tica e hipercoagulabilidad&#44; y no solo con el desarrollo de retinopat&#237;a hipertensiva&#46;</p><p id="par0155" class="elsevierStylePara elsevierViewall">Una alteraci&#243;n visual de nueva aparici&#243;n durante el embarazo o en el posparto&#44; incluso en ausencia de HTA&#44; deber&#237;a hacernos sospechar un DRE en el contexto de una preeclampsia grave o un s&#237;ndrome de HELLP&#46;</p></span><span id="sec0025" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="sect0045">Conflicto de intereses</span><p id="par0160" class="elsevierStylePara elsevierViewall">Los autores declaran no tener ning&#250;n conflicto de intereses&#46;</p></span></span>"
    "textoCompletoSecciones" => array:1 [
      "secciones" => array:10 [
        0 => array:3 [
          "identificador" => "xres1655172"
          "titulo" => "Resumen"
          "secciones" => array:1 [
            0 => array:1 [
              "identificador" => "abst0005"
            ]
          ]
        ]
        1 => array:2 [
          "identificador" => "xpalclavsec1471266"
          "titulo" => "Palabras clave"
        ]
        2 => array:3 [
          "identificador" => "xres1655173"
          "titulo" => "Abstract"
          "secciones" => array:1 [
            0 => array:1 [
              "identificador" => "abst0010"
            ]
          ]
        ]
        3 => array:2 [
          "identificador" => "xpalclavsec1471267"
          "titulo" => "Keywords"
        ]
        4 => array:2 [
          "identificador" => "sec0005"
          "titulo" => "Introducci&#243;n"
        ]
        5 => array:2 [
          "identificador" => "sec0010"
          "titulo" => "Caso cl&#237;nico"
        ]
        6 => array:2 [
          "identificador" => "sec0015"
          "titulo" => "Discusi&#243;n"
        ]
        7 => array:2 [
          "identificador" => "sec0020"
          "titulo" => "Conclusiones"
        ]
        8 => array:2 [
          "identificador" => "sec0025"
          "titulo" => "Conflicto de intereses"
        ]
        9 => array:1 [
          "titulo" => "Bibliograf&#237;a"
        ]
      ]
    ]
    "pdfFichero" => "main.pdf"
    "tienePdf" => true
    "fechaRecibido" => "2020-07-21"
    "fechaAceptado" => "2020-11-24"
    "PalabrasClave" => array:2 [
      "es" => array:1 [
        0 => array:4 [
          "clase" => "keyword"
          "titulo" => "Palabras clave"
          "identificador" => "xpalclavsec1471266"
          "palabras" => array:5 [
            0 => "Desprendimiento de retina exudativo"
            1 => "Preeclampsia severa"
            2 => "S&#237;ndrome de HELLP"
            3 => "Preeclampsia at&#237;pica"
            4 => "Hipertensi&#243;n arterial"
          ]
        ]
      ]
      "en" => array:1 [
        0 => array:4 [
          "clase" => "keyword"
          "titulo" => "Keywords"
          "identificador" => "xpalclavsec1471267"
          "palabras" => array:5 [
            0 => "Exudative retinal detachment"
            1 => "Severe preeclampsia"
            2 => "HELLP syndrome"
            3 => "Atypical preeclampsia"
            4 => "Arterial hypertension"
          ]
        ]
      ]
    ]
    "tieneResumen" => true
    "resumen" => array:2 [
      "es" => array:2 [
        "titulo" => "Resumen"
        "resumen" => "<span id="abst0005" class="elsevierStyleSection elsevierViewall"><p id="spar0005" class="elsevierStyleSimplePara elsevierViewall">El desprendimiento de retina exudativo &#40;DRE&#41; es una rara complicaci&#243;n que afecta al 1&#37; de preeclampsias&#44; aumentando su incidencia cuando se asocia con s&#237;ndrome de HELLP&#46;</p><p id="spar0010" class="elsevierStyleSimplePara elsevierViewall">La preeclampsia se define por el inicio de hipertensi&#243;n arterial y proteinuria tras la 20&#46;&#170; semana de gestaci&#243;n hasta el posparto&#46; EL s&#237;ndrome de HELLP &#40;trombocitopenia&#44; hem&#243;lisis y elevaci&#243;n de enzimas hep&#225;ticas&#41; constituye una forma severa de preeclampsia&#46;</p><p id="spar0015" class="elsevierStyleSimplePara elsevierViewall">El DRE en la preeclampsia est&#225; relacionado con isquemia coroidal&#44; en la mayor&#237;a de los casos asociado a retinopat&#237;a hipertensiva&#46; Sin embargo&#44; se ha propuesto que la combinaci&#243;n de hipertensi&#243;n junto a microangiopat&#237;a hemol&#237;tica&#44; hipercoagulabilidad e hipoalbuminemia son los principales factores implicados en el DRE&#46;</p><p id="spar0020" class="elsevierStyleSimplePara elsevierViewall">Su tratamiento incluye una resoluci&#243;n r&#225;pida del parto para revertir las manifestaciones oculares y prevenir secuelas visuales&#46;</p><p id="spar0025" class="elsevierStyleSimplePara elsevierViewall">Se describe el caso de una gestante con preeclampsia at&#237;pica que&#44; en el posparto de una ces&#225;rea&#44; present&#243; un DRE concomitante con un s&#237;ndrome de HELLP&#46;</p></span>"
      ]
      "en" => array:2 [
        "titulo" => "Abstract"
        "resumen" => "<span id="abst0010" class="elsevierStyleSection elsevierViewall"><p id="spar0030" class="elsevierStyleSimplePara elsevierViewall">Exudative retinal detachment &#40;ERD&#41; is a rare complication that occurring in 1&#37; of patients with preeclampsia&#44; its incidence is increased when it is associated with HELLP syndrome&#46;</p><p id="spar0035" class="elsevierStyleSimplePara elsevierViewall">Preeclampsia is defined by the development of arterial hypertension and proteinuira occurs after 20 weeks of gestation until postpartum&#46; HELLP syndrome &#40;low platelets&#44; hemolysis and elevated liver enzymes&#41; is a severe form of preeclampsia&#46;</p><p id="spar0040" class="elsevierStyleSimplePara elsevierViewall">ERD in preeclampsia is related to choroidal ischaemia&#44; in the vast majority of the cases associated with hypertensive retinopathy&#46; However&#44; it has been proposed that the combination of hypertension with a microangiopathic hemolysis&#44; hipercoagulability and hypoalbuminemia are the main factors contributing to the development of ERD&#46;</p><p id="spar0045" class="elsevierStyleSimplePara elsevierViewall">Its treatment includes a rapid resolution of labor to reverse ocular manifestations and prevent visual sequels&#46;</p><p id="spar0050" class="elsevierStyleSimplePara elsevierViewall">We describe the case of a pregnant woman with atypical preeclampsia who&#44; in the postpartum of a cesarean&#44; presented an ERD concomitantly with a HELLP syndrome&#46;</p></span>"
      ]
    ]
    "multimedia" => array:3 [
      0 => array:7 [
        "identificador" => "fig0005"
        "etiqueta" => "Figura 1"
        "tipo" => "MULTIMEDIAFIGURA"
        "mostrarFloat" => true
        "mostrarDisplay" => false
        "figura" => array:1 [
          0 => array:4 [
            "imagen" => "gr1.jpeg"
            "Alto" => 1924
            "Ancho" => 2175
            "Tamanyo" => 332370
          ]
        ]
        "descripcion" => array:1 [
          "es" => "<p id="spar0055" class="elsevierStyleSimplePara elsevierViewall">Desprendimiento de retina exudativo temporo-inferior bulloso con afectaci&#243;n macular localizado en ambos ojos&#46;</p>"
        ]
      ]
      1 => array:8 [
        "identificador" => "tbl0005"
        "etiqueta" => "Tabla 1"
        "tipo" => "MULTIMEDIATABLA"
        "mostrarFloat" => true
        "mostrarDisplay" => false
        "detalles" => array:1 [
          0 => array:3 [
            "identificador" => "at1"
            "detalle" => "Tabla "
            "rol" => "short"
          ]
        ]
        "tabla" => array:1 [
          "tablatextoimagen" => array:1 [
            0 => array:2 [
              "tabla" => array:1 [
                0 => """
                  <table border="0" frame="\n
                  \t\t\t\t\tvoid\n
                  \t\t\t\t" class=""><thead title="thead"><tr title="table-row"><th class="td" title="\n
                  \t\t\t\t\ttable-head\n
                  \t\t\t\t  " align="" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t" scope="col" style="border-bottom: 2px solid black">&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t\t\t</th><th class="td" title="\n
                  \t\t\t\t\ttable-head\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t" scope="col" style="border-bottom: 2px solid black">Ingreso&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t\t\t</th><th class="td" title="\n
                  \t\t\t\t\ttable-head\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t" scope="col" style="border-bottom: 2px solid black">Posparto&#40;6<span class="elsevierStyleHsp" style=""></span>h en Rea&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t\t\t</th><th class="td" title="\n
                  \t\t\t\t\ttable-head\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t" scope="col" style="border-bottom: 2px solid black">1&#46;&#176; d&#237;aen Rea&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t\t\t</th><th class="td" title="\n
                  \t\t\t\t\ttable-head\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t" scope="col" style="border-bottom: 2px solid black">2&#46;&#176; d&#237;aen Rea&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t\t\t</th><th class="td" title="\n
                  \t\t\t\t\ttable-head\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t" scope="col" style="border-bottom: 2px solid black">3&#46;&#176; d&#237;aen Rea&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t\t\t</th><th class="td" title="\n
                  \t\t\t\t\ttable-head\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t" scope="col" style="border-bottom: 2px solid black">4&#46;&#176; d&#237;aen Rea&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t\t\t</th><th class="td" title="\n
                  \t\t\t\t\ttable-head\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t" scope="col" style="border-bottom: 2px solid black">5&#46;&#176;d&#237;aAlta Rea&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t\t\t</th><th class="td" title="\n
                  \t\t\t\t\ttable-head\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t" scope="col" style="border-bottom: 2px solid black">Altahospital&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t\t\t</th></tr></thead><tbody title="tbody"><tr title="table-row"><td class="td-with-role" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t ; entry_with_role_rowhead " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">TA mmHg &#40;media en 24h&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">118&#47;85&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">135&#47;85&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">125&#47;80&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">130&#47;75&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">125&#47;75&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">140&#47;85&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">130&#47;75&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">122&#47;76&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t ; entry_with_role_rowhead " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">Creatinina &#40;mg&#47;dl&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">1&#44;46&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">1&#44;71&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">2&#44;46&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">2&#44;81&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">1&#44;88&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">1&#44;32&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">1&#44;13&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">0&#44;75&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t ; entry_with_role_rowhead " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">Prote&#237;nas orina &#40;mg&#47;dl&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">500&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">-&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">-&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">-&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">-&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">-&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">-&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">-&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t ; entry_with_role_rowhead " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">&#205;ndice PO&#47;creat &#40;mg&#47;mg&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">2&#44;08&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">-&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">-&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">-&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">-&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">-&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">-&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">-&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t ; entry_with_role_rowhead " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">Hemoglobina &#40;g&#47;dl&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">15&#44;4&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">12&#44;5&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">10&#44;8&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">12&#44;1&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">11&#44;6&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">10&#44;4&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">10&#44;2&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">9&#44;1&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t ; entry_with_role_rowhead " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">Plaquetas &#40;mil&#47;mcl&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">221&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">98&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">44&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">53&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">73&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">86&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">121&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">272&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t ; entry_with_role_rowhead " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">Leucocitos &#40;mil&#47;mcl&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">14&#44;53&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">29&#44;7&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">26&#44;1&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">24&#44;1&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">21&#44;5&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">19&#44;3&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">18&#44;2&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">12&#44;4&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t ; entry_with_role_rowhead " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">LDH &#40;U&#47;L&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">376&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">1152&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">991&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">759&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">-&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">558&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">597&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">106&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t ; entry_with_role_rowhead " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">AST&#40;U&#47;L&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">54&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">70&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">56&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">33&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">-&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">35&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">33&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">17&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t ; entry_with_role_rowhead " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">ALT &#40;U&#47;L&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">34&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">30&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">28&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">22&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">24&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">22&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">24&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">22&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t ; entry_with_role_rowhead " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">Bilirrubina &#40;mg&#47;dl&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">0&#44;3&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">0&#44;9&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">0&#44;4&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">0&#44;3&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">-&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">0&#44;3&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">0&#44;4&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">0&#44;2&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t ; entry_with_role_rowhead " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">Haptoglobina &#40;mg&#47;dl&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">-&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">-&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">18&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">-&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">-&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">-&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">-&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">-&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr></tbody></table>
                  """
              ]
              "imagenFichero" => array:1 [
                0 => "xTab2817606.png"
              ]
            ]
          ]
        ]
        "descripcion" => array:1 [
          "es" => "<p id="spar0060" class="elsevierStyleSimplePara elsevierViewall">Par&#225;metros de laboratorio durante el ingreso&#47;alta en Reanimaci&#243;n y al alta hospitalaria</p>"
        ]
      ]
      2 => array:8 [
        "identificador" => "tbl0010"
        "etiqueta" => "Tabla 2"
        "tipo" => "MULTIMEDIATABLA"
        "mostrarFloat" => true
        "mostrarDisplay" => false
        "detalles" => array:1 [
          0 => array:3 [
            "identificador" => "at2"
            "detalle" => "Tabla "
            "rol" => "short"
          ]
        ]
        "tabla" => array:2 [
          "leyenda" => "<p id="spar0070" class="elsevierStyleSimplePara elsevierViewall">SUHA&#58; s&#237;ndrome ur&#233;mico hemol&#237;tico at&#237;pico asociado al embarazo&#59; PTT&#58; p&#250;rpura trobocitop&#233;nica tromb&#243;tica&#59; 0&#58; poco probable o no presente&#59; 1<span class="elsevierStyleHsp" style=""></span>&#43;<span class="elsevierStyleHsp" style=""></span>&#58; poco probable&#59; 2<span class="elsevierStyleHsp" style=""></span>&#43;<span class="elsevierStyleHsp" style=""></span>&#58; moderadamente probable&#59; 3<span class="elsevierStyleHsp" style=""></span>&#43;<span class="elsevierStyleHsp" style=""></span>&#58; severo o altamente probable&#46;</p><p id="spar0075" class="elsevierStyleSimplePara elsevierViewall">Adaptada de Vijayan M&#46; et al&#46;<a class="elsevierStyleCrossRef" href="#bib0100"><span class="elsevierStyleSup">10</span></a>&#46;</p>"
          "tablatextoimagen" => array:1 [
            0 => array:2 [
              "tabla" => array:1 [
                0 => """
                  <table border="0" frame="\n
                  \t\t\t\t\tvoid\n
                  \t\t\t\t" class=""><thead title="thead"><tr title="table-row"><th class="td" title="\n
                  \t\t\t\t\ttable-head\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t" scope="col" style="border-bottom: 2px solid black">Par&#225;metro&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t\t\t</th><th class="td" title="\n
                  \t\t\t\t\ttable-head\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t" scope="col" style="border-bottom: 2px solid black">Preeclampsia&#47; HELLP&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t\t\t</th><th class="td" title="\n
                  \t\t\t\t\ttable-head\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t" scope="col" style="border-bottom: 2px solid black">PTT&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t\t\t</th><th class="td" title="\n
                  \t\t\t\t\ttable-head\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t" scope="col" style="border-bottom: 2px solid black">SUHA&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t\t\t</th></tr></thead><tbody title="tbody"><tr title="table-row"><td class="td-with-role" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t ; entry_with_role_rowhead " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">Incidencia m&#225;xima&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">3&#46;&#176; trimestre y posparto&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">2&#46;&#176; o 3&#46;&#176; trimestre&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">Posparto&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t ; entry_with_role_rowhead " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">HTA<span class="elsevierStyleHsp" style=""></span>&#62; 140&#47;90 mmHg&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">3&#43;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">0 a 3&#43;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">2&#43;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t ; entry_with_role_rowhead " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">Proteinuria&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">1<span class="elsevierStyleHsp" style=""></span>&#43;<span class="elsevierStyleHsp" style=""></span>a 3&#43;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">1<span class="elsevierStyleHsp" style=""></span>&#43;<span class="elsevierStyleHsp" style=""></span>a 3&#43;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">1<span class="elsevierStyleHsp" style=""></span>&#43;<span class="elsevierStyleHsp" style=""></span>a 3&#43;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t ; entry_with_role_rowhead " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">Dolor abdominal&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">0<span class="elsevierStyleHsp" style=""></span>&#43;<span class="elsevierStyleHsp" style=""></span>a 3&#43;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">0 a 1<span class="elsevierStyleHsp" style=""></span>&#43;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">0 a 1<span class="elsevierStyleHsp" style=""></span>&#43;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t ; entry_with_role_rowhead " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">Elevaci&#243;n de AST&#47;ALT&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">0 a 3<span class="elsevierStyleHsp" style=""></span>&#43;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">0 a 1<span class="elsevierStyleHsp" style=""></span>&#43;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">0 a 1<span class="elsevierStyleHsp" style=""></span>&#43;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t ; entry_with_role_rowhead " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">D&#233;ficit neurol&#243;gico&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">0 a 3<span class="elsevierStyleHsp" style=""></span>&#43;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">2<span class="elsevierStyleHsp" style=""></span>&#43;<span class="elsevierStyleHsp" style=""></span>a 3<span class="elsevierStyleHsp" style=""></span>&#43;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">0 a 1<span class="elsevierStyleHsp" style=""></span>&#43;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t ; entry_with_role_rowhead " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">Trombocitopenia&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">0 a 3<span class="elsevierStyleHsp" style=""></span>&#43;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">2<span class="elsevierStyleHsp" style=""></span>&#43;<span class="elsevierStyleHsp" style=""></span>a 3<span class="elsevierStyleHsp" style=""></span>&#43;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">3<span class="elsevierStyleHsp" style=""></span>&#43;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t ; entry_with_role_rowhead " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">Hem&#243;lisisEsquistocitos<span class="elsevierStyleHsp" style=""></span>&#62; 1&#37;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">1<span class="elsevierStyleHsp" style=""></span>&#43;<span class="elsevierStyleHsp" style=""></span>a 3<span class="elsevierStyleHsp" style=""></span>&#43;0 a 2<span class="elsevierStyleHsp" style=""></span>&#43;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">1<span class="elsevierStyleHsp" style=""></span>&#43;<span class="elsevierStyleHsp" style=""></span>a 3<span class="elsevierStyleHsp" style=""></span>&#43;<span class="elsevierStyleHsp" style=""></span>3<span class="elsevierStyleHsp" style=""></span>&#43;<span class="elsevierStyleHsp" style=""></span>&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">1<span class="elsevierStyleHsp" style=""></span>&#43;<span class="elsevierStyleHsp" style=""></span>a 3<span class="elsevierStyleHsp" style=""></span>&#43;2<span class="elsevierStyleHsp" style=""></span>&#43;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t ; entry_with_role_rowhead " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">Disfunci&#243;n renal&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">1<span class="elsevierStyleHsp" style=""></span>&#43;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">1<span class="elsevierStyleHsp" style=""></span>&#43;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">3<span class="elsevierStyleHsp" style=""></span>&#43;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t ; entry_with_role_rowhead " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">Fiebre&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">0&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">1<span class="elsevierStyleHsp" style=""></span>&#43;<span class="elsevierStyleHsp" style=""></span>a 3<span class="elsevierStyleHsp" style=""></span>&#43;<span class="elsevierStyleHsp" style=""></span>&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">0 a 3<span class="elsevierStyleHsp" style=""></span>&#43;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t ; entry_with_role_rowhead " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">Tratamiento&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">Finalizar el parto&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">Plasmaf&#233;resis&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">Plasmaf&#233;resis &#47; eculizumab&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr></tbody></table>
                  """
              ]
              "imagenFichero" => array:1 [
                0 => "xTab2817605.png"
              ]
            ]
          ]
        ]
        "descripcion" => array:1 [
          "es" => "<p id="spar0065" class="elsevierStyleSimplePara elsevierViewall">Diagn&#243;stico diferencial de la lesi&#243;n renal asociada al embarazo</p>"
        ]
      ]
    ]
    "bibliografia" => array:2 [
      "titulo" => "Bibliograf&#237;a"
      "seccion" => array:1 [
        0 => array:2 [
          "identificador" => "bibs0015"
          "bibliografiaReferencia" => array:10 [
            0 => array:3 [
              "identificador" => "bib0055"
              "etiqueta" => "1"
              "referencia" => array:1 [
                0 => array:2 [
                  "contribucion" => array:1 [
                    0 => array:2 [
                      "titulo" => "Preeclamptic serous retinal detachment without hypertension&#58; A case report"
                      "autores" => array:1 [
                        0 => array:2 [
                          "etal" => false
                          "autores" => array:3 [
                            0 => "S&#46;A&#46; Hussain"
                            1 => "B&#46;J&#46; O&#39;Shea"
                            2 => "A&#46;S&#46; Thagard"
                          ]
                        ]
                      ]
                    ]
                  ]
                  "host" => array:1 [
                    0 => array:2 [
                      "doi" => "10.1016/j.crwh.2019.e00098"
                      "Revista" => array:4 [
                        "tituloSerie" => "Case Reports in Women&#39;s Health&#46;"
                        "fecha" => "2019"
                        "volumen" => "21"
                        "paginaInicial" => "e00098"
                      ]
                    ]
                  ]
                ]
              ]
            ]
            1 => array:3 [
              "identificador" => "bib0060"
              "etiqueta" => "2"
              "referencia" => array:1 [
                0 => array:2 [
                  "contribucion" => array:1 [
                    0 => array:2 [
                      "titulo" => "Retinal detachment in association with pre-eclampsia&#44; eclampsia&#44; and HELLP syndrome"
                      "autores" => array:1 [
                        0 => array:2 [
                          "etal" => false
                          "autores" => array:2 [
                            0 => "P&#46; Vigil-De Gracia"
                            1 => "L&#46; Ortega-Paz"
                          ]
                        ]
                      ]
                    ]
                  ]
                  "host" => array:1 [
                    0 => array:2 [
                      "doi" => "10.1016/j.ijgo.2011.04.003"
                      "Revista" => array:6 [
                        "tituloSerie" => "Int J Gynaecol Obstet"
                        "fecha" => "2011"
                        "volumen" => "114"
                        "paginaInicial" => "223"
                        "paginaFinal" => "225"
                        "link" => array:1 [
                          0 => array:2 [
                            "url" => "https://www.ncbi.nlm.nih.gov/pubmed/21719013"
                            "web" => "Medline"
                          ]
                        ]
                      ]
                    ]
                  ]
                ]
              ]
            ]
            2 => array:3 [
              "identificador" => "bib0065"
              "etiqueta" => "3"
              "referencia" => array:1 [
                0 => array:2 [
                  "contribucion" => array:1 [
                    0 => array:2 [
                      "titulo" => "Bilateral vision loss after delivery in two cases&#58; Severe preeclampsia and HELLP syndrome"
                      "autores" => array:1 [
                        0 => array:2 [
                          "etal" => false
                          "autores" => array:4 [
                            0 => "G&#46; &#199;elik"
                            1 => "A&#46; Eser"
                            2 => "M&#46; G&#252;nay"
                            3 => "N&#46;M&#46; Yenerel"
                          ]
                        ]
                      ]
                    ]
                  ]
                  "host" => array:1 [
                    0 => array:2 [
                      "doi" => "10.4274/tjo.45722"
                      "Revista" => array:7 [
                        "tituloSerie" => "Turk J Ophthalmol&#46;"
                        "fecha" => "2015"
                        "volumen" => "45"
                        "paginaInicial" => "271"
                        "paginaFinal" => "273"
                        "link" => array:1 [
                          0 => array:2 [
                            "url" => "https://www.ncbi.nlm.nih.gov/pubmed/27800247"
                            "web" => "Medline"
                          ]
                        ]
                        "itemHostRev" => array:3 [
                          "pii" => "S1063458415012315"
                          "estado" => "S300"
                          "issn" => "10634584"
                        ]
                      ]
                    ]
                  ]
                ]
              ]
            ]
            3 => array:3 [
              "identificador" => "bib0070"
              "etiqueta" => "4"
              "referencia" => array:1 [
                0 => array:2 [
                  "contribucion" => array:1 [
                    0 => array:2 [
                      "titulo" => "Rare case of exudative retinal detachment in normotensive HELLP syndrome&#58; A case Report"
                      "autores" => array:1 [
                        0 => array:2 [
                          "etal" => false
                          "autores" => array:6 [
                            0 => "A&#46; Singh"
                            1 => "I&#46; Yadav"
                            2 => "S&#46; Deshmukh"
                            3 => "P&#46; Rajendra"
                            4 => "R&#46;P&#46; Maurya"
                            5 => "S&#46; Pandey"
                          ]
                        ]
                      ]
                    ]
                  ]
                  "host" => array:1 [
                    0 => array:2 [
                      "doi" => "10.5958/2395-1451.2015.00013.x"
                      "Revista" => array:5 [
                        "tituloSerie" => "Indian J of clinic Experimental Ophthalmol&#46;"
                        "fecha" => "2015"
                        "volumen" => "1"
                        "paginaInicial" => "187"
                        "paginaFinal" => "188"
                      ]
                    ]
                  ]
                ]
              ]
            ]
            4 => array:3 [
              "identificador" => "bib0075"
              "etiqueta" => "5"
              "referencia" => array:1 [
                0 => array:2 [
                  "contribucion" => array:1 [
                    0 => array:2 [
                      "titulo" => "HELLP syndrome with unilateral exudative retinal detachment treated conservatively"
                      "autores" => array:1 [
                        0 => array:2 [
                          "etal" => false
                          "autores" => array:4 [
                            0 => "A&#46;V&#46; Pradeep"
                            1 => "S&#46; Rao"
                            2 => "R&#46; Ramesh Kumar"
                            3 => "Partial"
                          ]
                        ]
                      ]
                    ]
                  ]
                  "host" => array:1 [
                    0 => array:2 [
                      "doi" => "10.1016/j.sjopt.2014.03.011"
                      "Revista" => array:6 [
                        "tituloSerie" => "Saudi J Ophthalmol"
                        "fecha" => "2014"
                        "volumen" => "28"
                        "paginaInicial" => "329"
                        "paginaFinal" => "331"
                        "link" => array:1 [
                          0 => array:2 [
                            "url" => "https://www.ncbi.nlm.nih.gov/pubmed/25473354"
                            "web" => "Medline"
                          ]
                        ]
                      ]
                    ]
                  ]
                ]
              ]
            ]
            5 => array:3 [
              "identificador" => "bib0080"
              "etiqueta" => "6"
              "referencia" => array:1 [
                0 => array:2 [
                  "contribucion" => array:1 [
                    0 => array:2 [
                      "titulo" => "Bilateral retinal detachment&#58; a clue to diagnosis of HELLP syndrome"
                      "autores" => array:1 [
                        0 => array:2 [
                          "etal" => false
                          "autores" => array:5 [
                            0 => "V&#46; Gogia"
                            1 => "S&#46; Sharma"
                            2 => "D&#46; Deka"
                            3 => "V&#46; Dadhwal"
                            4 => "P&#46; Venkatesh"
                          ]
                        ]
                      ]
                    ]
                  ]
                  "host" => array:1 [
                    0 => array:2 [
                      "doi" => "10.1016/j.jcjo.2013.09.009"
                      "Revista" => array:6 [
                        "tituloSerie" => "Can J Ophthalmol&#46;"
                        "fecha" => "2014"
                        "volumen" => "49"
                        "paginaInicial" => "e5"
                        "paginaFinal" => "e8"
                        "link" => array:1 [
                          0 => array:2 [
                            "url" => "https://www.ncbi.nlm.nih.gov/pubmed/24513381"
                            "web" => "Medline"
                          ]
                        ]
                      ]
                    ]
                  ]
                ]
              ]
            ]
            6 => array:3 [
              "identificador" => "bib0085"
              "etiqueta" => "7"
              "referencia" => array:1 [
                0 => array:2 [
                  "contribucion" => array:1 [
                    0 => array:2 [
                      "titulo" => "Exudative retinal detachment in eclampsia&#46; A management dilemma"
                      "autores" => array:1 [
                        0 => array:2 [
                          "etal" => false
                          "autores" => array:5 [
                            0 => "A&#46;K&#46; Mohan"
                            1 => "R&#46;N&#46; Al-Senawi"
                            2 => "M&#46; Mathew"
                            3 => "A&#46; Ganesh"
                            4 => "A&#46; Al-Mujaini"
                          ]
                        ]
                      ]
                    ]
                  ]
                  "host" => array:1 [
                    0 => array:1 [
                      "Revista" => array:6 [
                        "tituloSerie" => "Saudi Med J"
                        "fecha" => "2009"
                        "volumen" => "30"
                        "paginaInicial" => "302"
                        "paginaFinal" => "303"
                        "link" => array:1 [
                          0 => array:2 [
                            "url" => "https://www.ncbi.nlm.nih.gov/pubmed/19198726"
                            "web" => "Medline"
                          ]
                        ]
                      ]
                    ]
                  ]
                ]
              ]
            ]
            7 => array:3 [
              "identificador" => "bib0090"
              "etiqueta" => "8"
              "referencia" => array:1 [
                0 => array:2 [
                  "contribucion" => array:1 [
                    0 => array:2 [
                      "titulo" => "Bilateral serous retinal detachment as a complication of HELLP syndrome"
                      "autores" => array:1 [
                        0 => array:2 [
                          "etal" => false
                          "autores" => array:5 [
                            0 => "P&#46;G&#46; Tranos"
                            1 => "S&#46;S&#46; Wickremasinghe"
                            2 => "K&#46;S&#46; Hundal"
                            3 => "P&#46;J&#46; Foster"
                            4 => "J&#46; Jagger"
                          ]
                        ]
                      ]
                    ]
                  ]
                  "host" => array:1 [
                    0 => array:2 [
                      "doi" => "10.1038/sj.eye.6700056"
                      "Revista" => array:5 [
                        "tituloSerie" => "Eye&#46;"
                        "fecha" => "2002"
                        "volumen" => "16"
                        "paginaInicial" => "491"
                        "paginaFinal" => "492"
                      ]
                    ]
                  ]
                ]
              ]
            ]
            8 => array:3 [
              "identificador" => "bib0095"
              "etiqueta" => "9"
              "referencia" => array:1 [
                0 => array:2 [
                  "contribucion" => array:1 [
                    0 => array:2 [
                      "titulo" => "Bilateral serous retinal detachment in a woman with HELLP syndrome&#46; HELLP syndrome and retinal detachment"
                      "autores" => array:1 [
                        0 => array:2 [
                          "etal" => false
                          "autores" => array:4 [
                            0 => "H&#46; Karaguzel"
                            1 => "S&#46; Guven"
                            2 => "A&#46; Karalezli"
                            3 => "H&#46; Erdol"
                          ]
                        ]
                      ]
                    ]
                  ]
                  "host" => array:1 [
                    0 => array:2 [
                      "doi" => "10.1080/01443610902736916"
                      "Revista" => array:6 [
                        "tituloSerie" => "J Obstet Gynaecol&#46;"
                        "fecha" => "2014"
                        "volumen" => "29"
                        "paginaInicial" => "246"
                        "paginaFinal" => "248"
                        "link" => array:1 [
                          0 => array:2 [
                            "url" => "https://www.ncbi.nlm.nih.gov/pubmed/19358039"
                            "web" => "Medline"
                          ]
                        ]
                      ]
                    ]
                  ]
                ]
              ]
            ]
            9 => array:3 [
              "identificador" => "bib0100"
              "etiqueta" => "10"
              "referencia" => array:1 [
                0 => array:2 [
                  "contribucion" => array:1 [
                    0 => array:2 [
                      "titulo" => "Acute kidney injury in pregnancy"
                      "autores" => array:1 [
                        0 => array:2 [
                          "etal" => false
                          "autores" => array:4 [
                            0 => "M&#46; Vijayan"
                            1 => "M&#46; Avendano"
                            2 => "K&#46; Chinchilla"
                            3 => "B&#46; Jim"
                          ]
                        ]
                      ]
                    ]
                  ]
                  "host" => array:1 [
                    0 => array:2 [
                      "doi" => "10.1097/mcc.0000000000000656"
                      "Revista" => array:6 [
                        "tituloSerie" => "Curr Opin Crit Care&#46;"
                        "fecha" => "2019"
                        "volumen" => "25"
                        "paginaInicial" => "580"
                        "paginaFinal" => "590"
                        "link" => array:1 [
                          0 => array:2 [
                            "url" => "https://www.ncbi.nlm.nih.gov/pubmed/31524717"
                            "web" => "Medline"
                          ]
                        ]
                      ]
                    ]
                  ]
                ]
              ]
            ]
          ]
        ]
      ]
    ]
  ]
  "idiomaDefecto" => "es"
  "url" => "/00349356/0000006900000002/v1_202201260835/S0034935621000153/v1_202201260835/es/main.assets"
  "Apartado" => array:4 [
    "identificador" => "7568"
    "tipo" => "SECCION"
    "es" => array:2 [
      "titulo" => "Casos cl&#237;nicos"
      "idiomaDefecto" => true
    ]
    "idiomaDefecto" => "es"
  ]
  "PDF" => "https://static.elsevier.es/multimedia/00349356/0000006900000002/v1_202201260835/S0034935621000153/v1_202201260835/es/main.pdf?idApp=UINPBA00004N&text.app=https://www.elsevier.es/"
  "EPUB" => "https://multimedia.elsevier.es/PublicationsMultimediaV1/item/epub/S0034935621000153?idApp=UINPBA00004N"
]
Información del artículo
ISSN: 00349356
Idioma original: Español
Datos actualizados diariamente
año/Mes Html Pdf Total
2024 Abril 1 2 3
2023 Diciembre 1 1 2
2023 Abril 1 2 3
2022 Julio 1 2 3
2022 Junio 1 8 9
2022 Mayo 2 0 2
2022 Abril 5 0 5
2022 Marzo 4 3 7
2022 Febrero 45 17 62
2022 Enero 6 2 8
2021 Septiembre 0 2 2

Siga este enlace para acceder al texto completo del artículo

es en pt

¿Es usted profesional sanitario apto para prescribir o dispensar medicamentos?

Are you a health professional able to prescribe or dispense drugs?

Você é um profissional de saúde habilitado a prescrever ou dispensar medicamentos