Hispanopedia Wiki
Articulo de referencia

Rivalta test

Positive Rivalta test of a FIP-Aspiration. For visualisation the fluid was colored by Methylenic blue. Certain diseases can cause excessive accumulations of fluid in areas of th...

Hispanopedia WikiContenido en espanolLectura gratuita
Positive Rivalta test of a FIP-Aspiration. For visualisation the fluid was colored by Methylenic blue.

Certain diseases can cause excessive accumulations of fluid in areas of the body such as the abdomen (ascites) or the pleural space around the lungs (pleural effusion) or the pericardial space around the heart. An estimate of the concentration of protein in such fluids can narrow the differential diagnosis and assist the clinician in establishing a diagnosis. For example, fluid accumulations due to congestive heart failure and liver failure (cirrhosis) are typically lower in protein content and are called transudates whereas fluid accumulations due to cancer and tuberculosis are typically higher in protein content and are called exudates. The Rivalta Test is a simple, inexpensive method that can be used in resource-limited settings to differentiate a transudate from an exudate.[1] It is a simple, inexpensive method that does not require special laboratory equipment and can be easily performed in private practice. The test was originally developed by the Italian researcher Rivalta around 1900 and was used to differentiate transudates and exudates in human patients. It is also useful in cats to differentiate between effusions due to feline infectious peritonitis (FIP) and effusions caused by other diseases.[2] Not only the high protein content, but high concentrations of fibrinogen and inflammatory mediators lead to a positive reaction.

Method

A test tube is filled with distilled water and acetic acid is added. To this mixture one drop of the effusion to be tested is added. If the drop dissipates, the test is negative, indicating a transudate. If the drop precipitates, the test is positive, indicating an exudate.[3]

Using a pH 4.0 acetic acid solution, 8 types of proteins were identified in Rivalta reaction-positive turbid precipitates: C-reactive protein (CRP), Alpha 1-antitrypsin (alpha1-AT), Orosomucoid ((Alpha-1-acid glycoprotein or AGP)), haptoglobin (Hp), transferrin (Tf), ceruloplasmin (Cp), fibrinogen (Fg), and hemopexin (Hpx). Since those are Acute-phase proteins, a positive Rivalta's test may be suggestive of inflammation.[4]

Procedure

Para realizar esta prueba, se llena un tubo de ensayo transparente (10 ml) con aproximadamente 7-8 ml de agua destilada, al que se añade una gota de ácido acético (8%, vinagre blanco común) y se mezcla bien. Sobre la superficie de esta solución, se deposita cuidadosamente una gota del líquido de derrame. Si la gota desaparece y la solución permanece transparente, la prueba de Rivalta se considera negativa. Si la gota conserva su forma, permanece adherida a la superficie o se hunde lentamente hasta el fondo del tubo (como una gota o una medusa), la prueba de Rivalta se considera positiva.

La prueba de Rivalta tuvo un alto valor predictivo positivo (86 %) y un valor predictivo negativo muy alto para la PIF (96 %) en un estudio en el que se investigaron gatos que presentaban derrame (prevalencia de PIF 51 %). [ 2 ] Los resultados positivos de la prueba de Rivalta pueden ocurrir en gatos con peritonitis bacteriana o linfoma.

Referencias

  1. ↑ Berti-Bock G, Vial F, Premuda L, Rullière R (noviembre de 1979). "[Exudados, transudados y la reacción de Rivalta (1895). Estado actual y premisas históricas]". Minerva Med. (en italiano). 70 (52): 3573– 80. PMID 392338 . 
  2. 1 2 Hartmann et al., 2003
  3. ↑ "PERITONITIS INFECCIOSA FELINA (PIF) (RESUMEN)" . Archivado del original el 25 de abril de 2009. Consultado el 24 de junio de 2009 .
  4. ^ Sakai N, Iijima S, Shiba K (noviembre de 2004). "Reinvestigación del valor clínico de la reacción de Rivalta del líquido de punción". Rinsho Byori . 52 (11 ) : 877–82.PMID 15658465 . 
  • http://abcd-vets.org/guidelines/feline_infectious_peritonitis/chapter-5.asp