[Importance of the protein profile in internal medicine].
Until recent years, main biologic markers of inflammation used in current practice were limited to erythrocyte sedimentation rate, fibrinogen, and serum protein electrophoresis. A better understanding of inflammatory mechanisms and improvement of laboratories technologies helped in better understanding of the role and potential usefulness of inflammatory reaction proteins. Arrival of proteic profile and, more recently, the development of automation, still improved analysis of variations of different inflammatory reaction proteins. These proteins are then analyzed as an element of a "functional biological system", with known and so expected kinetics and ranges. The analyze of proteic profile combines the analyze of proteins variations, with elected but not exclusive associations, as Immunoglobulins and Complement, Orosomucoid and Haptoglobin, or Albumin and Transferrin. In Internal Medicine, proteic profile may help in solving daily problems. These problems may be so schematized: when the fundamental pathology is not yet known in an unraveling check-up, facing clinical symptoms, with a normal or fewly disrupted usual biologic panel, proteic profile may help to choose investigations necessary for the diagnosis; in the follow-up of patients treated for known inflammatory pathology facing new symptoms, part has to be done between complication of the disease and/or of the treatment, new pathology associated or unefficiency of the treatment. We report herein part of our experience of proteic profile in an Internal Medicine department, from some particularly demonstrative case reports: congenital or acquired abnormality of iron metabolism, with normal usual iron panel (iron deficiency, hemochromatosis); severe evolutive inflammatory or infectious disease with normal erythrocyte sedimentation rate (temporal arteritis, infectious endocarditis).
Cacoub
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Service de Médecine Interne, C.H.U. Pitié-Salpétrière, Paris.
Thiolières
J M
JM
D000209:Acute-Phase Proteins / Q000032:analysis*; D000328:Adult; D000368:Aged; D000747:Anemia, Hypochromic / Q000097:blood / Q000150:complications / Q000175:diagnosis; D004697:Endocarditis, Bacterial / Q000097:blood / Q000150:complications / Q000175:diagnosis; D005260:Female; D005335:Fever of Unknown Origin / Q000097:blood / Q000209:etiology; D013700:Giant Cell Arteritis / Q000097:blood / Q000150:complications; D006432:Hemochromatosis / Q000097:blood / Q000175:diagnosis; D006801:Humans; D007388:Internal Medicine; D008180:Lupus Erythematosus, Systemic / Q000097:blood / Q000150:complications; D008297:Male; D008875:Middle Aged; D011183:Postoperative Complications; D011655:Pulmonary Embolism / Q000097:blood / Q000150:complications / Q000175:diagnosis; D013203:Staphylococcal Infections / Q000097:blood / Q000150:complications / Q000175:diagnosis
D000209:Acute-Phase Proteins