Estrategias diagnósticas utilizadas para detectar deficiencias de hierro subclínicas y asociadas a enfermedades crónicas
Diagnostic Strategies for Detecting Subclinical Iron Deficiencies and Associated to Chronic Diseases
Diagnostic Strategies for Detecting Subclinical Iron Deficiencies and Associated to Chronic Diseases
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La homeostasis y las variaciones fisiológicas horarias en el metabolismo del hierro se constituyen en verdaderos desafíos para los expertos, quienes intentan diseñar pruebas altamente sensibles y específicas que cuantifiquen los niveles circulantes y de depósito de este elemento, su repercusión en la eritropoyesis, cuantificación de las proteínas, transportadores y receptores involucrados en el proceso, a fin de descartar la presencia de estados carenciales. Las deficiencias de hierro pasan por tres fases; las dos primeras son las más difíciles de identificar porque son subclínicas, más aún, cuando pueden cursar simultáneamente con enfermedades crónicas inflamatorias, infecciosas y neoplásicas que de por sí son anemizantes. En este trabajo se revisarán las principales pruebas de laboratorio utilizadas para la identificación de deficiencias de hierro, sensibilidad, especificidad, ventajas y limitaciones para su uso Diagnostic strategies for detecting subclinical iron deficiencies and associated to chronic diseases: Due to the homeostasis and the hourly physiological variations in iron’s metabolism, quantifying, both circulating and stored iron, has become a challenge for the experts that try to design highly sensitive and specific tests to quantify not only the levels of circulating and stored iron, but also its effects in erithropoiesis, and the proteins, transporters and receptors involved in the process in order to discard its deficiency. Iron deficiencies go through three stages; the first two are the most difficult to identify because they are sub-clinical and because they can appear simultaneously with chronic diseases inflammatory infectious, neoplacics which cause anemia. In this paper, the principal laboratory tests used to identify iron deficiencies will be reviewed, referring to their sensibility, specificity, advantages and their used limitations.
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