Article

Interpretación de las pruebas de laboratorio habituales en las enfermedades reumatológicas inflamatorias

EMC - Tratado de Medicina 01/2006; 10(1):1–9. DOI: 10.1016/S1636-5410(06)70375-0

ABSTRACT Resulta difícil identificar la causa de las poliartritis en fase inicial, y no existe un acuerdo sobre las pruebas de laboratorio o radiológicas que se deben realizar en estos casos. Al revisar la literatura reciente, se ha podido comprobar que los artículos relativos a este tema, con cohortes de reumatismos en fase inicial, son menos de 30, y tratan sobre todo los factores reumatoideos, los anticuerpos anticitrulina y la tipificación del antígeno HLA. Una encuesta de opinión demuestra que, aunque existen grandes variaciones, las pruebas de laboratorio que se prescriben en las fases iniciales de los reumatismos inflamatorios son limitadas (NFS, VSG, CRP, fibrina, creatinina, ASAT, ALAT, proteinuria, hierro, CPK, serología de hepatitis B, de hepatitis C y de Lyme, TCA, anticuerpos antinucleares, factores reumatoideos, anticuerpos antiqueratina o anti-CCP y HLA B27). Una vez establecido el diagnóstico, el laboratorio sigue siendo esencial para la detección de afecciones viscerales y para el seguimiento de la inflamación.

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