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Vol. 17. Núm. 1.
Páginas 35-47 (Marzo 2010)
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Vol. 17. Núm. 1.
Páginas 35-47 (Marzo 2010)
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Evaluación de la inflamación en el laboratorio
Laboratory evaluation of inflammation
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136410
Luis Alonso González Naranjo1, José Fernando Molina Restrepo2
1 Médico especialista en Medicina Interna y Reumatología. Profesor asistente, sección de Reumatología, Hospital Universitario San Vicente de Paúl, Universidad de Antioquia. Medellín, Colombia
2 Médico especialista en Medicina Interna y Reumatología. Profesor asociado de Reumatología, CES. Clínica Las Américas, Medellín, Colombia
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La respuesta de fase aguda refleja la inflamación tanto aguda como crónica en curso y se presenta en una amplia variedad de condiciones inflamatorias como infecciones, trauma, cirugías, quemaduras, neoplasias, enfermedades reumáticas inflamatorias y ciertas reacciones inmunes a drogas. La velocidad de sedimentación globular (VSG) y la presencia de leucocitosis con desviación a la izquierda son marcadores diagnósticos de enfermedades inflamatorias e infecciosas. Además, la medición de los niveles séricos de las proteínas de fase aguda, particularmente la proteína C reactiva (PCR), es útil en tres situaciones patológicas: infección, inflamación aguda o crónica y en la evaluación del riesgo metabólico. Procalcitonina es un marcador útil de sepsis e infecciones graves. Los niveles elevados de ferritina son característicos de la enfermedad de Still del adulto y el síndrome hemofagocítico, ambos asociados con la inflamación. Aunque los niveles séricos de citoquinas son cruciales para la generación de la inflamación, su utilidad en la clínica está aún bajo investigación. Las concentraciones séricas de los inhibidores de citocinas o receptores solubles de citoquinas, podría aportar información importante para el seguimiento de las enfermedades autoinflamatorias.

Palabras clave:
inflamación
proteínas de fase aguda
enfermedades reumáticas
citoquinas
proteína C reactiva
velocidad de sedimentación globular
Summary

The acute phase response reflects of inflammation both acute and ongoing chronic inflammation and occurs in a wide variety of inflammatory conditions such as infections, trauma, surgery, burns, malignancies, inflammatory rheumatic and certain immune reactions drug. The erythrocyte sedimentation rate and leukocytosis with left shift are diagnostic markers for inflammatory and infectious diseases. The levels of acute-phase proteins, especially C-reactive protein, are used to assess both the presence of inflammation and any response to treatment. The measurement of C-reactive protein levels is useful in three types of pathological situation: infection, acute or chronic inflammation, and evaluation of metabolic risk. Procalcitonin is an useful marker of sepsis and severe infection. High levels of ferritin are characteristic of adult-onset Still's disease and hemophagocytic syndrome, both associated with inflammation. Although serum levels of cytokines are crucial for the generation of inflammation, their usefulness in the clinic is still under investigation. Serum concentrations of cytokine inhibitors or soluble cytokine receptors could provide important information for monitoring autoinflammatory diseases.

Key words:
inflammation
acute-phase proteins
rheumatic diseases
cytokines
C-reactive protein
erythrocyte sedimentation rate
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