{"id":1077,"date":"2011-08-18T18:28:00","date_gmt":"2011-08-18T23:28:00","guid":{"rendered":"http:\/\/medicinainterna.com.mx\/2011\/08\/18\/sistema-de-puntuacion-para-realizar-diagnostico-de-hepatitis-autoinmunes-atipicas-en-adultos"},"modified":"2011-08-18T18:28:00","modified_gmt":"2011-08-18T23:28:00","slug":"sistema-de-puntuacion-para-realizar-diagnostico-de-hepatitis-autoinmunes-atipicas-en-adultos","status":"publish","type":"post","link":"https:\/\/medicinainterna.com.mx\/?p=1077","title":{"rendered":"Sistema de puntuaci\u00f3n para realizar diagn\u00f3stico de hepatitis autoinmunes at\u00edpicas en adultos."},"content":{"rendered":"
<\/div>\n\n\n\n\n\n\n\n\n\n\n\n\n\n\n\n\n\n
Categor\u00eda <\/em><\/strong><\/td>\nFactor <\/em><\/strong><\/td>\nScore <\/em><\/strong><\/td>\n<\/tr>\n
Sexo<\/td>\nFemenino<\/td>\n+2<\/td>\n<\/tr>\n
Relaci\u00f3n FAL\/GOT (o GPT)<\/td>\n>3<\/p>\n

<1,5<\/td>\n

-2<\/p>\n

+2<\/td>\n<\/tr>\n

Gammaglobulina o IgG (veces sobre el l\u00edmite superior normal)<\/td>\n>2,0<\/p>\n

1,5-2,0<\/p>\n

1,0-1,5<\/p>\n

<1,0<\/td>\n

+3<\/p>\n

+2<\/p>\n

+1<\/p>\n

0<\/td>\n<\/tr>\n

T\u00edtulos de ANA, SMA, o anti-LKM1<\/td>\n>1:80<\/p>\n

1:80<\/p>\n

1:40<\/p>\n

<1:40<\/td>\n

+3<\/p>\n

+2<\/p>\n

+1<\/p>\n

0<\/td>\n<\/tr>\n

AMA<\/td>\nPositivo<\/td>\n-4<\/td>\n<\/tr>\n
Marcadores virales de infecci\u00f3n activa<\/td>\nPositivo<\/p>\n

Negativo<\/td>\n

-3<\/p>\n

+3<\/td>\n<\/tr>\n

Drogas hepatot\u00f3xicas<\/td>\nSi<\/p>\n

No<\/td>\n

-4<\/p>\n

+1<\/td>\n<\/tr>\n

Alcohol<\/td>\n<25 g\/d<\/p>\n

>60 g\/d<\/td>\n

+2<\/p>\n

-2<\/td>\n<\/tr>\n

Enfermedad autoinmune concurrente<\/td>\nCualquier enfermedad no-hep\u00e1tica de origen inmune<\/td>\n+2<\/td>\n<\/tr>\n
Otros autoanticuerpos<\/td>\nAnti-SLA\/LP, actina, LC1, pANCA<\/td>\n+2<\/td>\n<\/tr>\n
Caracter\u00edsticas histol\u00f3gicas<\/td>\nInterfase de hepatitis<\/p>\n

C\u00e9lulas plasm\u00e1ticas<\/p>\n

Rosetas<\/p>\n

Ninguna de las de arriba<\/p>\n

Cambios biliares<\/p>\n

Caracter\u00edsticas at\u00edpicas<\/td>\n

+3<\/p>\n

+1<\/p>\n

+1<\/p>\n

-5<\/p>\n

-3<\/p>\n

-3<\/td>\n<\/tr>\n

HLA<\/td>\nDR3 o DR4<\/td>\n+1<\/td>\n<\/tr>\n
Respuesta al tratamiento<\/td>\nRemisi\u00f3n completa<\/p>\n

Remisi\u00f3n con reca\u00edda<\/td>\n

+2<\/p>\n

+3<\/td>\n<\/tr>\n

Score pretratamiento<\/strong><\/p>\n

Diagn\u00f3stico definitivo >15<\/p>\n

Diagn\u00f3stico probable 10-15<\/td>\n

Score posttratamiento<\/strong><\/p>\n

Diagn\u00f3stico definitivo >17<\/p>\n

Diagn\u00f3stico probable 12-17<\/td>\n<\/tr>\n<\/tbody>\n<\/table>\n

En base a la evidencia, las recomendaciones actuales con respecto al diagn\u00f3stico de la hepatitis autoinmune son las siguientes:<\/p>\n

El diagn\u00f3stico de hepatitis autoinmune requiere la determinaci\u00f3n de niveles de aminotransferasas s\u00e9ricas y de gammaglobulinas; detecci\u00f3n de ANA y\/o SMA, o en su ausencia, anti-LKM1; y examen histol\u00f3gico de biopsia hep\u00e1tica.<\/p>\n

Los criterios diagn\u00f3sticos de hepatitis autoinmune deben ser aplicados a todos los pacientes.<\/p>\n

Si el diagn\u00f3stico de hepatitis autoinmune no est\u00e1 claro, se debe utilizar el m\u00e9todo de puntuaci\u00f3n o score.<\/p>\n

Fuente: Firman, Guillermo. http:\/\/www.intermedicina.com\/Avances\/Clinica\/ACL65.htm<\/p>\n

\"\"<\/div>\n","protected":false},"excerpt":{"rendered":"

Categor\u00eda Factor Score Sexo Femenino +2 Relaci\u00f3n FAL\/GOT (o GPT) >3 <1,5 -2 +2 Gammaglobulina o IgG (veces sobre el l\u00edmite superior normal) >2,0 1,5-2,0 1,0-1,5 <1,0 +3 +2 +1 0 T\u00edtulos de ANA, SMA, o anti-LKM1 >1:80 1:80 1:40 <1:40 +3 +2 +1 0 AMA Positivo -4 Marcadores virales de infecci\u00f3n activa Positivo Negativo … Continue reading “Sistema de puntuaci\u00f3n para realizar diagn\u00f3stico de hepatitis autoinmunes at\u00edpicas en adultos.”<\/span><\/a><\/p>\n","protected":false},"author":2,"featured_media":0,"comment_status":"open","ping_status":"open","sticky":false,"template":"","format":"standard","meta":{"_jetpack_memberships_contains_paid_content":false,"footnotes":""},"categories":[6],"tags":[25,35],"class_list":["post-1077","post","type-post","status-publish","format-standard","hentry","category-gastroenterologia","tag-autoinmune","tag-hepatitis"],"jetpack_sharing_enabled":true,"jetpack_featured_media_url":"","_links":{"self":[{"href":"https:\/\/medicinainterna.com.mx\/index.php?rest_route=\/wp\/v2\/posts\/1077","targetHints":{"allow":["GET"]}}],"collection":[{"href":"https:\/\/medicinainterna.com.mx\/index.php?rest_route=\/wp\/v2\/posts"}],"about":[{"href":"https:\/\/medicinainterna.com.mx\/index.php?rest_route=\/wp\/v2\/types\/post"}],"author":[{"embeddable":true,"href":"https:\/\/medicinainterna.com.mx\/index.php?rest_route=\/wp\/v2\/users\/2"}],"replies":[{"embeddable":true,"href":"https:\/\/medicinainterna.com.mx\/index.php?rest_route=%2Fwp%2Fv2%2Fcomments&post=1077"}],"version-history":[{"count":0,"href":"https:\/\/medicinainterna.com.mx\/index.php?rest_route=\/wp\/v2\/posts\/1077\/revisions"}],"wp:attachment":[{"href":"https:\/\/medicinainterna.com.mx\/index.php?rest_route=%2Fwp%2Fv2%2Fmedia&parent=1077"}],"wp:term":[{"taxonomy":"category","embeddable":true,"href":"https:\/\/medicinainterna.com.mx\/index.php?rest_route=%2Fwp%2Fv2%2Fcategories&post=1077"},{"taxonomy":"post_tag","embeddable":true,"href":"https:\/\/medicinainterna.com.mx\/index.php?rest_route=%2Fwp%2Fv2%2Ftags&post=1077"}],"curies":[{"name":"wp","href":"https:\/\/api.w.org\/{rel}","templated":true}]}}