ANALIZAN EL PAPEL DE LOS ANTICUERPOS ANTI-CITOPLASMA DE LOS NEUTROFILOS (ANCA) EN LA ENFERMEDAD INFLAMATORIA INTESTINAL

Los marcadores serológicos anticuerpos anticitoplasma de los neutrófilos (pANCA) pueden considerarse en algunas circunstancias como un complemento de otros métodos diagnósticos, pero su utilidad en la práctica clínica es limitada y en ningún caso reemplazan el buen criterio clínico.

Autor:
Javier P. Gisbert
Columnista Experto de SIIC

Institución:
Hospital Universitario de la Princesa, Universidad Autónoma de Madrid

Artículos publicados por Javier P. Gisbert

Recepción del artículo
14 de Febrero, 2006

Aprobación
14 de Febrero, 2006

Primera edición
13 de Junio, 2006

Segunda edición, ampliada y corregida
7 de Junio, 2021

ANALIZAN EL PAPEL DE LOS ANTICUERPOS ANTI-CITOPLASMA DE LOS NEUTROFILOS (ANCA) EN LA ENFERMEDAD INFLAMATORIA INTESTINAL

Resumen
La prevalencia media de los anticuerpos anticitoplasma de los neutrófilos (pANCA), considerados clásicamente como marcador característico de la colitis ulcerosa (CU), es de poco más del 50% en los pacientes con esta enfermedad, una cifra que, aunque evidentemente más alta que la descrita en los controles sanos, dista mucho del valor ideal del 100%. Por otro lado, los pANCA se encuentran también presentes en un porcentaje considerable -de media el 17%- de los pacientes con enfermedad de Crohn (EC). La sensibilidad de los pANCA para el diagnóstico de la CU entre los pacientes con clínica compatible posee una sensibilidad subóptima (media del 58%), pero la especificidad es considerablemente elevada (media del 93%), por lo que un resultado positivo apoya con relativa seguridad el diagnóstico de CU. En las colitis indeterminadas el uso de estos marcadores serológicos podría aportarnos alguna información relevante, no sólo desde el punto de vista diagnóstico sino también terapéutico, por lo que su cuantificación podría ser una opción adecuada en este contexto. Diversos autores demostraron que los pacientes con EC y pANCA positivos, esto es, el marcador serológico típico de la CU, tienen características fenotípicas que mimetizan en parte a las de esta última enfermedad. La mayoría de los estudios demostraron que la presencia de pANCA no guarda relación con la actividad de la CU. En resumen, los marcadores serológicos pANCA pueden considerarse en algunas circunstancias como un complemento de otros métodos diagnósticos (como la radiología, la endoscopia o la histología), tienen una utilidad limitada en la práctica clínica y en ningún caso reemplazan el buen criterio clínico.

Palabras clave
enfermedad de Crohn, colitis ulcerosa, enfermedad inflamatoria intestinal, anticuerpos anti-citoplasma de los neutrófilos, ANCA, pANCA

Artículo completo
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Especialidades
Principal: Gastroenterología
Relacionadas: Bioquímica, Diagnóstico por Laboratorio, Inmunología, Medicina Interna

Enviar correspondencia a:
Javier P. Gisbert, Servicio de Aparato Digestivo. Hospital Universitario de la Princesa, Universidad Autónoma de Madrid, 28669, Playa de Mojácar 29, Urb. Bonanza, Boadilla del Monte, Madrid, España

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