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Medicina & Laboratorio

2010, Número 01-02

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Medicina & Laboratorio 2010; 16 (01-02)


Eritrosedimentación: réquiem para una prueba

Campuzano MG

Idioma: Español
Referencias bibliográficas: 415
Paginas: 11-40
Archivo PDF: 517.46 Kb.


RESUMEN

La eritrosedimentación es una de las pruebas más solicitadas al laboratorio clínico. Sin embargo, la utilidad clínica de la prueba en la amplia gama de situaciones clínicas en donde se la ha indicado en el curso de más de 100 años, paulatinamente ha perdido vigencia frente a la medición de otros analitos como los reactantes de fase aguda, en particular la proteína C reactiva, para el diagnóstico y manejo de las enfermedades infecciosas e inflamatorias, incluidas las de origen reumatológico y las enfermedades cardiovasculares, y los marcadores tumorales en las enfermedades malignas. La eritrosedimentación, además de ser altamente inespecífica, depende de métodos manuales e implica alto riesgo profesional por los accidentes relacionados con las pipetas de vidrio que se utilizan para hacer la prueba. En este módulo se presenta, tras una exhaustiva revisión bibliográfica de PubMed y Scielo, las indicaciones en donde la prueba fue de utilidad y las alternativas para reemplazarla por pruebas de mejor desempeño analítico y mejor relación costo-eficiencia. Se hace un llamado a la comunidad médica para que antes de solicitarla al laboratorio clínico consideren otras opciones de mayor sensibilidad, especificidad, valor predictivo positivo y valor predictivo negativo que la eritrosedimentación, en cada una de las situaciones clínicas que la requiera.


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