{"id":10002,"date":"2023-04-12T20:13:00","date_gmt":"2023-04-12T20:13:00","guid":{"rendered":"https:\/\/medicalcriteria.com\/web\/?p=10002"},"modified":"2025-12-30T19:47:28","modified_gmt":"2025-12-30T19:47:28","slug":"rheumatoid-cachexia","status":"publish","type":"post","link":"https:\/\/medicalcriteria.com\/web\/es\/rheumatoid-cachexia\/","title":{"rendered":"Criterios Diagn\u00f3stico para Caquexia Reumatoide"},"content":{"rendered":"<div class=\"7ca9444b8380138fe077da07353677a4\" data-index=\"1\" style=\"float: none; margin:0px 0 0px 0; text-align:center;\">\n<script async src=\"https:\/\/pagead2.googlesyndication.com\/pagead\/js\/adsbygoogle.js\"><\/script>\r\n<!-- MC 2019- Horizontal -->\r\n<ins class=\"adsbygoogle\"\r\n     style=\"display:block\"\r\n     data-ad-client=\"ca-pub-0127150553352455\"\r\n     data-ad-slot=\"3806776041\"\r\n     data-ad-format=\"auto\"\r\n     data-full-width-responsive=\"true\"><\/ins>\r\n<script>\r\n     (adsbygoogle = window.adsbygoogle || []).push({});\r\n<\/script>\n<\/div>\n<p>La caquexia en la artritis reumatoide (caquexia reumatoide, CR), se caracteriza principalmente por la p\u00e9rdida de masa muscular, en particular de masa magra apendicular (ALM), y asociada a masa grasa acumulada (FM), situada principalmente en la zona del tronco, indicando un cambio hacia el desarrollo de la obesidad abdominal. La p\u00e9rdida de masa celular corporal (BCM) constituye un importante tema de preocupaci\u00f3n para los pacientes con AR. La BCM est\u00e1 formada principalmente por masa muscular y visceral (eritrocitos, prote\u00ednas s\u00e9ricas, linfocitos, etc.), y es la parte del organismo con mayor actividad metab\u00f3lica (95% de la actividad total), determinando los requerimientos proteicos, el gasto energ\u00e9tico y la Respuesta metab\u00f3lica al estr\u00e9s.<!--more--><\/p>\n<p>Los criterios de diagn\u00f3stico para CR difieren mucho entre los estudios, con varios investigadores que adoptaron los criterios de Engvall, algunos diagnosticaron RC utilizando los criterios de Elkan y otros los criterios de M\u00fcller para el diagn\u00f3stico de RC.<\/p>\n<p><strong>Criterios Diagn\u00f3stico para Caquexia Reumatoide<\/strong><\/p>\n<table style=\"border-collapse: collapse; width: 100%; height: 166px;\" border=\"1\">\n<tbody>\n<tr style=\"height: 48px;\">\n<td style=\"width: 11.1111%; height: 48px;\"><strong><span style=\"font-size: 10pt;\">Diagn\u00f3stico<\/span><\/strong><\/td>\n<td style=\"width: 6.21172%; height: 48px;\"><strong><span style=\"font-size: 10pt;\">Autor<\/span><\/strong><\/td>\n<td style=\"width: 13.8232%; height: 48px; text-align: center;\"><strong><span style=\"font-size: 10pt;\">P\u00e9rdida de peso\u2020<\/span><\/strong><\/td>\n<td style=\"width: 9.14256%; height: 48px; text-align: center;\"><strong><span style=\"font-size: 10pt;\">FFMI (kg\/m2)<\/span><\/strong><\/td>\n<td style=\"width: 9.53629%; height: 48px; text-align: center;\"><strong><span style=\"font-size: 10pt;\">FMI <\/span><span style=\"font-size: 10pt;\">(kg\/m2)<\/span><\/strong><\/td>\n<td style=\"width: 11.3735%; height: 48px; text-align: center;\"><strong><span style=\"font-size: 10pt;\">GC<\/span><\/strong><br \/>\n<strong><span style=\"font-size: 10pt;\">(% of PC)<\/span><\/strong><\/td>\n<td style=\"width: 10.7174%; height: 48px; text-align: center;\"><strong><span style=\"font-size: 10pt;\">P\u00e9rdida de fuerza <\/span><span style=\"font-size: 10pt;\">muscular<\/span><\/strong><\/td>\n<td style=\"width: 6.25545%; height: 48px; text-align: center;\"><strong><span style=\"font-size: 10pt;\">Fatiga<\/span><\/strong><\/td>\n<td style=\"width: 10.0612%; height: 48px; text-align: center;\"><strong><span style=\"font-size: 10pt;\">Anorexia<\/span><\/strong><\/td>\n<td style=\"width: 11.7673%; height: 48px; text-align: center;\"><strong><span style=\"font-size: 10pt;\">Bioqu\u00edmica anormal<\/span><\/strong><\/td>\n<\/tr>\n<tr style=\"height: 24px;\">\n<td style=\"width: 11.1111%; height: 108px;\" rowspan=\"3\"><span style=\"font-size: 10pt;\">Caquexia Reumatoide<\/span><\/td>\n<td style=\"width: 6.21172%; height: 24px;\"><span style=\"font-size: 10pt;\">Engvall <\/span><\/td>\n<td style=\"width: 13.8232%; height: 24px; text-align: center;\"><\/td>\n<td style=\"width: 9.14256%; height: 24px; text-align: center;\"><span style=\"font-size: 10pt;\">&lt;10 PC*<\/span><\/td>\n<td style=\"width: 9.53629%; height: 24px; text-align: center;\"><span style=\"font-size: 10pt;\">&gt;25 <\/span><span style=\"font-size: 10pt;\">PC*<\/span><\/td>\n<td style=\"width: 11.3735%; height: 24px; text-align: center;\"><\/td>\n<td style=\"width: 10.7174%; height: 24px; text-align: center;\"><\/td>\n<td style=\"width: 6.25545%; height: 24px; text-align: center;\"><\/td>\n<td style=\"width: 10.0612%; height: 24px; text-align: center;\"><\/td>\n<td style=\"width: 11.7673%; height: 24px; text-align: center;\"><\/td>\n<\/tr>\n<tr style=\"height: 27px;\">\n<td style=\"width: 6.21172%; height: 27px;\"><span style=\"font-size: 10pt;\">Elkan <\/span><\/td>\n<td style=\"width: 13.8232%; height: 27px; text-align: center;\"><\/td>\n<td style=\"width: 9.14256%; height: 27px; text-align: center;\"><span style=\"font-size: 10pt;\">&lt;25 PC*<\/span><\/td>\n<td style=\"width: 9.53629%; height: 27px; text-align: center;\"><span style=\"font-size: 10pt;\">&gt;50 <\/span><span style=\"font-size: 10pt;\">PC*<\/span><\/td>\n<td style=\"width: 11.3735%; height: 27px; text-align: center;\"><\/td>\n<td style=\"width: 10.7174%; height: 27px; text-align: center;\"><\/td>\n<td style=\"width: 6.25545%; height: 27px; text-align: center;\"><\/td>\n<td style=\"width: 10.0612%; height: 27px; text-align: center;\"><\/td>\n<td style=\"width: 11.7673%; height: 27px; text-align: center;\"><\/td>\n<\/tr>\n<tr style=\"height: 96px;\">\n<td style=\"width: 6.21172%; height: 57px;\"><span style=\"font-size: 10pt;\">M\u00fcller<\/span><\/td>\n<td style=\"width: 13.8232%; height: 57px; text-align: center;\"><\/td>\n<td style=\"width: 9.14256%; height: 57px; text-align: center;\"><span style=\"font-size: 10pt;\">ALM\/peso<sup>2<\/sup><\/span><br \/>\n<span style=\"font-size: 10pt;\">&lt;20 PC*<\/span><\/td>\n<td style=\"width: 9.53629%; height: 57px; text-align: center;\"><\/td>\n<td style=\"width: 11.3735%; height: 57px; text-align: center;\"><span style=\"font-size: 10pt;\">&gt;25% para hombres<\/span><span style=\"font-size: 10pt;\">, <\/span><span style=\"font-size: 10pt;\">&gt;35% para mujeres<\/span><\/td>\n<td style=\"width: 10.7174%; height: 57px; text-align: center;\"><\/td>\n<td style=\"width: 6.25545%; height: 57px; text-align: center;\"><\/td>\n<td style=\"width: 10.0612%; height: 57px; text-align: center;\"><\/td>\n<td style=\"width: 11.7673%; height: 57px; text-align: center;\"><\/td>\n<\/tr>\n<tr style=\"height: 480px;\">\n<td style=\"width: 11.1111%; height: 10px;\"><span style=\"font-size: 10pt;\">Caquexia<\/span><\/td>\n<td style=\"width: 6.21172%; height: 10px;\"><span style=\"font-size: 10pt;\">Evans<\/span><\/td>\n<td style=\"width: 13.8232%; height: 10px; text-align: center;\"><span style=\"font-size: 10pt;\">\u22655% en los 12 meses previos<\/span><span style=\"font-size: 10pt;\">, <\/span><span style=\"font-size: 10pt;\">o menos en presencia de enfermedad<\/span><span style=\"font-size: 10pt;\">, <\/span><span style=\"font-size: 10pt;\">o IMC &lt;20 kg\/m2, m\u00e1s<\/span><span style=\"font-size: 10pt;\"> 3\/5 de los otros <\/span><span style=\"font-size: 10pt;\">criterios (en las <\/span><span style=\"font-size: 10pt;\">columnas de la derecha)<\/span><\/td>\n<td style=\"width: 9.14256%; height: 10px; text-align: center;\"><span style=\"font-size: 10pt;\">&lt;10 PC*, <\/span><span style=\"font-size: 10pt;\">o ASMI (por <\/span><span style=\"font-size: 10pt;\">DXA) &lt;7.25 e<\/span><span style=\"font-size: 10pt;\">n hombres y <\/span><span style=\"font-size: 10pt;\">&lt;5.45 en mujeres<\/span><\/td>\n<td style=\"width: 9.53629%; height: 10px; text-align: center;\"><\/td>\n<td style=\"width: 11.3735%; height: 10px; text-align: center;\"><\/td>\n<td style=\"width: 10.7174%; height: 10px; text-align: center;\"><span style=\"font-size: 10pt;\">+<\/span><br \/>\n<span style=\"font-size: 10pt;\">(evaluado por fuerza de agarre<\/span><span style=\"font-size: 10pt;\">)<\/span><\/td>\n<td style=\"width: 6.25545%; height: 10px; text-align: center;\"><span style=\"font-size: 10pt;\">+<\/span><\/td>\n<td style=\"width: 10.0612%; height: 10px; text-align: center;\"><span style=\"font-size: 10pt;\">+<\/span><br \/>\n<span style=\"font-size: 10pt;\">Limitada ingesta de alimentos<\/span><span style=\"font-size: 10pt;\"> (por ej. EI&lt;20 <\/span><span style=\"font-size: 10pt;\">kcal\/kg de PC\/<\/span><span style=\"font-size: 10pt;\">d\u00eda, o &lt;70% de ingesta de alimentos u<\/span><span style=\"font-size: 10pt;\">sual), <\/span><span style=\"font-size: 10pt;\">o pobre apetito<\/span><\/td>\n<td style=\"width: 11.7673%; height: 10px; text-align: center;\"><span style=\"font-size: 10pt;\">\u00b0 Marcadores inflamatorios elevados<\/span><span style=\"font-size: 10pt;\">\u00a0(CRP&gt;5.0 <\/span><span style=\"font-size: 10pt;\">mg\/L, o <\/span><span style=\"font-size: 10pt;\">IL-6 &gt;4.0 pg\/mL)<\/span><br \/>\n<span style=\"font-size: 10pt;\">\u00b0 Anemia <\/span><span style=\"font-size: 10pt;\">(Hb &lt;12 g\/dL)<\/span><br \/>\n<span style=\"font-size: 10pt;\">\u00b0 Alb\u00famina s\u00e9rica &lt;3.2 g\/<\/span><span style=\"font-size: 10pt;\">dL<\/span><\/td>\n<\/tr>\n<\/tbody>\n<\/table>\n<p>ALM: masa magra apendicular (suma del tejido magro en brazos y piernas: calculada por DXA); ASMI: \u00edndice m\u00fasculo esquel\u00e9tico del ap\u00e9ndice; IMC: \u00edndice de masa corporal; GC: grasa corporal; PC: peso corporal; PCR: prote\u00edna C reactiva; DXA: absorciometr\u00eda de rayos X de energ\u00eda dual; IE: aporte energ\u00e9tico; Hb: hemoglobina; IMF: \u00edndice de masa grasa; FFMI: \u00edndice de masa magra; IL-6: interleucina 6; CP: percentil; * de los valores espec\u00edficos de sexo, edad y etnia; \u2020: libre de edema.<\/p>\n<p>&nbsp;<\/p>\n<p><strong>Bibliograf\u00eda:<\/strong><\/p>\n<ol>\n<li>Efthymiou E, Grammatikopoulou MG, Gkiouras K, Efthymiou G, Zafiriou E, Goulis DG, Sakkas LI, Bogdanos DP. Time to Deal with Rheumatoid Cachexia: Prevalence, Diagnostic Criteria, Treatment Effects and Evidence for Management. Mediterr J Rheumatol. 2022 Sep 30;33(3):271-290. <a href=\"https:\/\/pubmed.ncbi.nlm.nih.gov\/36531417\/\" target=\"_blank\" rel=\"noopener\">[Medline]<\/a><\/li>\n<li>Hurtado-Torres GF, Gonz\u00e1lez-Baranda LL, Abud-Mendoza C. Rheumatoid cachexia and other nutritional alterations in rheumatologic diseases. Reumatol Clin. 2015 Sep-Oct;11(5):316-21. <a href=\"https:\/\/pubmed.ncbi.nlm.nih.gov\/26094123\/\" target=\"_blank\" rel=\"noopener\">[Medline]<\/a><\/li>\n<\/ol>\n<p>&nbsp;<\/p>\n<p>Creado Mar 13, 2023.<\/p>\n\n<div style=\"font-size: 0px; height: 0px; line-height: 0px; margin: 0; padding: 0; clear: both;\"><\/div>","protected":false},"excerpt":{"rendered":"<p>La caquexia en la artritis reumatoide (caquexia reumatoide, CR), se caracteriza principalmente por la p\u00e9rdida de masa muscular, en particular de masa magra apendicular (ALM), y asociada a masa grasa acumulada (FM), situada principalmente en la zona del tronco, indicando un cambio hacia el desarrollo de la obesidad abdominal. La p\u00e9rdida de masa celular corporal [&hellip;]<\/p>\n","protected":false},"author":2,"featured_media":0,"comment_status":"closed","ping_status":"open","sticky":false,"template":"","format":"standard","meta":{"_lmt_disableupdate":"no","_lmt_disable":"no","_exactmetrics_skip_tracking":false,"_exactmetrics_sitenote_active":false,"_exactmetrics_sitenote_note":"","_exactmetrics_sitenote_category":0,"footnotes":""},"categories":[45],"tags":[2562,2561,16,15,14,13,1291,1289],"class_list":["post-10002","post","type-post","status-publish","format-standard","hentry","category-rheumatology","tag-cachexia","tag-caquexia","tag-criteria","tag-criterios","tag-diagnostic","tag-diagnostico","tag-reumatoide","tag-rheumatoid"],"modified_by":"Guillermo Firman","_links":{"self":[{"href":"https:\/\/medicalcriteria.com\/web\/es\/wp-json\/wp\/v2\/posts\/10002","targetHints":{"allow":["GET"]}}],"collection":[{"href":"https:\/\/medicalcriteria.com\/web\/es\/wp-json\/wp\/v2\/posts"}],"about":[{"href":"https:\/\/medicalcriteria.com\/web\/es\/wp-json\/wp\/v2\/types\/post"}],"author":[{"embeddable":true,"href":"https:\/\/medicalcriteria.com\/web\/es\/wp-json\/wp\/v2\/users\/2"}],"replies":[{"embeddable":true,"href":"https:\/\/medicalcriteria.com\/web\/es\/wp-json\/wp\/v2\/comments?post=10002"}],"version-history":[{"count":17,"href":"https:\/\/medicalcriteria.com\/web\/es\/wp-json\/wp\/v2\/posts\/10002\/revisions"}],"predecessor-version":[{"id":10042,"href":"https:\/\/medicalcriteria.com\/web\/es\/wp-json\/wp\/v2\/posts\/10002\/revisions\/10042"}],"wp:attachment":[{"href":"https:\/\/medicalcriteria.com\/web\/es\/wp-json\/wp\/v2\/media?parent=10002"}],"wp:term":[{"taxonomy":"category","embeddable":true,"href":"https:\/\/medicalcriteria.com\/web\/es\/wp-json\/wp\/v2\/categories?post=10002"},{"taxonomy":"post_tag","embeddable":true,"href":"https:\/\/medicalcriteria.com\/web\/es\/wp-json\/wp\/v2\/tags?post=10002"}],"curies":[{"name":"wp","href":"https:\/\/api.w.org\/{rel}","templated":true}]}}