@article{Romero Sanquiz_2021, title={Ictericia de origen colestásico intrahepatico: Jaundice of intrahepatic cholestatic origin}, url={https://produccioncientificaluz.org/index.php/higadosano/article/view/37190}, DOI={10.5281/zenodo.5680129}, abstractNote={<p><span dir="ltr" style="left: 138.07px; top: 431.028px; font-size: 16.3766px; font-family: sans-serif; transform: scaleX(0.908557);" role="presentation">La ictericia es un signo clínico que en todo grupo etario, indica la presencia de una patología, bien en la </span><span dir="ltr" style="left: 138.07px; top: 450.914px; font-size: 16.3766px; font-family: sans-serif; transform: scaleX(0.894899);" role="presentation">esfera hepatobiliar o no. Se observa cuando los niveles de bilirrubina sérica aumentan, en forma </span><span dir="ltr" style="left: 138.07px; top: 470.849px; font-size: 16.3766px; font-family: sans-serif; transform: scaleX(0.863103);" role="presentation">conjugada o no conjugada. La historia clínica permi</span><span dir="ltr" style="left: 484.475px; top: 470.849px; font-size: 16.3766px; font-family: sans-serif; transform: scaleX(0.867019);" role="presentation">te una evaluación bastante exacta de la ictericia e </span><span dir="ltr" style="left: 138.07px; top: 490.735px; font-size: 16.3766px; font-family: sans-serif; transform: scaleX(0.861256);" role="presentation">incluye la realización de pruebas de laboratorio en las que se soliciten bilirrubina total y fraccionada, </span><span dir="ltr" style="left: 138.07px; top: 510.621px; font-size: 16.3766px; font-family: sans-serif; transform: scaleX(0.912341);" role="presentation">hematología, </span><span dir="ltr" style="left: 235.479px; top: 510.621px; font-size: 16.3766px; font-family: sans-serif; transform: scaleX(0.913267);" role="presentation">alanino </span><span dir="ltr" style="left: 294.713px; top: 510.621px; font-size: 16.3766px; font-family: sans-serif; transform: scaleX(0.899839);" role="presentation">transaminasa </span><span dir="ltr" style="left: 393.981px; top: 510.621px; font-size: 16.3766px; font-family: sans-serif;" role="presentation">-</span> <span dir="ltr" style="left: 409.578px; top: 510.621px; font-size: 16.3766px; font-family: sans-serif; transform: scaleX(0.879215);" role="presentation">ALT, </span><span dir="ltr" style="left: 448.145px; top: 510.621px; font-size: 16.3766px; font-family: sans-serif; transform: scaleX(0.922814);" role="presentation">aspartato </span><span dir="ltr" style="left: 522.2px; top: 510.621px; font-size: 16.3766px; font-family: sans-serif; transform: scaleX(0.896337);" role="presentation">transaminasa </span><span dir="ltr" style="left: 621.369px; top: 510.621px; font-size: 16.3766px; font-family: sans-serif;" role="presentation">-</span> <span dir="ltr" style="left: 636.625px; top: 510.621px; font-size: 16.3766px; font-family: sans-serif; transform: scaleX(0.922642);" role="presentation">AST, fosfatasa alcalina, γ</span><span dir="ltr" style="left: 817.97px; top: 510.621px; font-size: 16.3766px; font-family: sans-serif;" role="presentation">-</span><span dir="ltr" style="left: 138.07px; top: 530.507px; font-size: 16.3766px; font-family: sans-serif; transform: scaleX(0.945266);" role="presentation">gluta</span><span dir="ltr" style="left: 171.256px; top: 530.507px; font-size: 16.3766px; font-family: sans-serif; transform: scaleX(0.916924);" role="presentation">miltransferasa, </span><span dir="ltr" style="left: 280.734px; top: 530.507px; font-size: 16.3766px; font-family: sans-serif; transform: scaleX(0.947242);" role="presentation">tiempo </span><span dir="ltr" style="left: 338.445px; top: 530.507px; font-size: 16.3766px; font-family: sans-serif; transform: scaleX(0.881249);" role="presentation">de </span><span dir="ltr" style="left: 365.335px; top: 530.507px; font-size: 16.3766px; font-family: sans-serif; transform: scaleX(0.951083);" role="presentation">protrombina </span><span dir="ltr" style="left: 459.632px; top: 530.507px; font-size: 16.3766px; font-family: sans-serif; transform: scaleX(0.842412);" role="presentation">y </span><span dir="ltr" style="left: 477.171px; top: 530.507px; font-size: 16.3766px; font-family: sans-serif; transform: scaleX(1.09237);" role="presentation">/ </span><span dir="ltr" style="left: 493.924px; top: 530.507px; font-size: 16.3766px; font-family: sans-serif; transform: scaleX(0.869953);" role="presentation">o </span><span dir="ltr" style="left: 512.626px; top: 530.507px; font-size: 16.3766px; font-family: sans-serif; transform: scaleX(0.93904);" role="presentation">proporción </span><span dir="ltr" style="left: 596.393px; top: 530.507px; font-size: 16.3766px; font-family: sans-serif; transform: scaleX(0.903331);" role="presentation">normalizada </span><span dir="ltr" style="left: 687.938px; top: 530.507px; font-size: 16.3766px; font-family: sans-serif; transform: scaleX(0.929493);" role="presentation">internacional </span><span dir="ltr" style="left: 785.33px; top: 530.507px; font-size: 16.3766px; font-family: sans-serif; transform: scaleX(0.8447);" role="presentation">(INR), </span><span dir="ltr" style="left: 138.07px; top: 550.392px; font-size: 16.3766px; font-family: sans-serif; transform: scaleX(0.913944);" role="presentation">proteograma sérico (1</span><span dir="ltr" style="left: 292.943px; top: 550.392px; font-size: 16.3766px; font-family: sans-serif;" role="presentation">-</span><span dir="ltr" style="left: 298.012px; top: 550.392px; font-size: 16.3766px; font-family: sans-serif; transform: scaleX(0.906001);" role="presentation">3). Los estudios por imágenes pueden permitir identificar patologías en el </span><span dir="ltr" style="left: 138.07px; top: 569.888px; font-size: 16.3766px; font-family: sans-serif; transform: scaleX(0.872599);" role="presentation">parénquima hepático y/o en las vías biliares. La hiperbilirrubinemia n</span><span dir="ltr" style="left: 617.08px; top: 569.888px; font-size: 16.3766px; font-family: sans-serif; transform: scaleX(0.8676);" role="presentation">o conjugada o indirecta hacen </span><span dir="ltr" style="left: 138.07px; top: 589.774px; font-size: 16.3766px; font-family: sans-serif; transform: scaleX(0.886554);" role="presentation">sospechar en procesos hemolíticos, en el síndrome de Gilbert y la hiperbilirrubinemia conjugada o </span><span dir="ltr" style="left: 138.07px; top: 609.693px; font-size: 16.3766px; font-family: sans-serif; transform: scaleX(0.926103);" role="presentation">directa, </span><span dir="ltr" style="left: 196.895px; top: 609.693px; font-size: 16.3766px; font-family: sans-serif; transform: scaleX(0.909757);" role="presentation">en daño </span><span dir="ltr" style="left: 263.941px; top: 609.693px; font-size: 16.3766px; font-family: sans-serif; transform: scaleX(0.926668);" role="presentation">hepatocelular, </span><span dir="ltr" style="left: 367.572px; top: 609.693px; font-size: 16.3766px; font-family: sans-serif; transform: scaleX(0.912857);" role="presentation">como </span><span dir="ltr" style="left: 413.165px; top: 609.693px; font-size: 16.3766px; font-family: sans-serif; transform: scaleX(0.930145);" role="presentation">hepatitis </span><span dir="ltr" style="left: 479.015px; top: 609.693px; font-size: 16.3766px; font-family: sans-serif; transform: scaleX(0.921057);" role="presentation">viral, </span><span dir="ltr" style="left: 519.908px; top: 609.693px; font-size: 16.3766px; font-family: sans-serif; transform: scaleX(0.888768);" role="presentation">daño </span><span dir="ltr" style="left: 561.226px; top: 609.693px; font-size: 16.3766px; font-family: sans-serif; transform: scaleX(0.911278);" role="presentation">por Desorden </span><span dir="ltr" style="left: 664.873px; top: 609.693px; font-size: 16.3766px; font-family: sans-serif; transform: scaleX(0.881969);" role="presentation">en </span><span dir="ltr" style="left: 689.815px; top: 609.693px; font-size: 16.3766px; font-family: sans-serif; transform: scaleX(0.888881);" role="presentation">el </span><span dir="ltr" style="left: 710.056px; top: 609.693px; font-size: 16.3766px; font-family: sans-serif; transform: scaleX(0.86251);" role="presentation">Uso </span><span dir="ltr" style="left: 743.972px; top: 609.693px; font-size: 16.3766px; font-family: sans-serif; transform: scaleX(0.879809);" role="presentation">de </span><span dir="ltr" style="left: 768.914px; top: 609.693px; font-size: 16.3766px; font-family: sans-serif; transform: scaleX(0.908576);" role="presentation">Alcohol, </span><span dir="ltr" style="left: 138.07px; top: 629.579px; font-size: 16.3766px; font-family: sans-serif; transform: scaleX(0.911883);" role="presentation">trastornos colestásicos, como cole</span><span dir="ltr" style="left: 366.687px; top: 629.579px; font-size: 16.3766px; font-family: sans-serif; transform: scaleX(0.915759);" role="presentation">docolitiasis y neoplasias en el confluente biliopancreatico. En cuanto </span><span dir="ltr" style="left: 138.07px; top: 649.465px; font-size: 16.3766px; font-family: sans-serif; transform: scaleX(0.793801);" role="presentation">a la</span> <span dir="ltr" style="left: 167.747px; top: 649.465px; font-size: 16.3766px; font-family: sans-serif; transform: scaleX(0.848601);" role="presentation">Colestasis es un trastorno hepatobiliar agudo o crónico, en el que la sintesis, secreción o flujo de </span><span dir="ltr" style="left: 138.07px; top: 669.35px; font-size: 16.3766px; font-family: sans-serif; transform: scaleX(0.906045);" role="presentation">bilis se encuentran alteradas. La colestasis</span> <span dir="ltr" style="left: 425.954px; top: 669.35px; font-size: 16.3766px; font-family: sans-serif; transform: scaleX(0.923856);" role="presentation">puede afectar hasta un 10</span><span dir="ltr" style="left: 601.873px; top: 669.35px; font-size: 16.3766px; font-family: sans-serif;" role="presentation">-</span><span dir="ltr" style="left: 606.942px; top: 669.35px; font-size: 16.3766px; font-family: sans-serif; transform: scaleX(0.912927);" role="presentation">20% de la población general. (1) </span><span dir="ltr" style="left: 138.07px; top: 689.236px; font-size: 16.3766px; font-family: sans-serif; transform: scaleX(0.905543);" role="presentation">Cuando la etiologia es benigna, lo cual representa el mayor porcentaje de los casos, no se asocia a una </span><span dir="ltr" style="left: 138.07px; top: 708.732px; font-size: 16.3766px; font-family: sans-serif; transform: scaleX(0.920717);" role="presentation">alta morbi</span><span dir="ltr" style="left: 208.688px; top: 708.732px; font-size: 16.3766px; font-family: sans-serif;" role="presentation">-</span><span dir="ltr" style="left: 213.367px; top: 708.732px; font-size: 16.3766px; font-family: sans-serif; transform: scaleX(0.872298);" role="presentation">mortalidad, cuando es prolongada y severa, puede progresar a fibrosis hepatica, c</span><span dir="ltr" style="left: 778.978px; top: 708.732px; font-size: 16.3766px; font-family: sans-serif; transform: scaleX(0.904362);" role="presentation">irrosis, </span><span dir="ltr" style="left: 138.07px; top: 728.618px; font-size: 16.3766px; font-family: sans-serif; transform: scaleX(0.915749);" role="presentation">carcinoma hepatocelular o colangiocarcinoma y la muerte puede ocurrir. </span></p&gt;}, number={22}, journal={Revista Profesional HígadoSano}, author={Romero Sanquiz, Gisela}, year={2021}, month={nov.}, pages={11-27} }