{"id":7896,"date":"2025-06-19T09:08:08","date_gmt":"2025-06-19T09:08:08","guid":{"rendered":"https:\/\/neuropediatoolkit.org\/?p=7896"},"modified":"2025-06-19T09:08:25","modified_gmt":"2025-06-19T09:08:25","slug":"diagrama-de-reiber","status":"publish","type":"post","link":"https:\/\/neuropediatoolkit.org\/en\/diagrama-de-reiber\/","title":{"rendered":"Reiber diagram"},"content":{"rendered":"\n<p>El <strong>Diagrama de Reiber<\/strong> es una herramienta gr\u00e1fica dise\u00f1ada para analizar el <strong>comportamiento de las inmunoglobulinas (IgG, IgA o IgM)<\/strong> en el l\u00edquido cefalorraqu\u00eddeo (LCR) y distinguir si su presencia se debe a una <strong>s\u00edntesis intratecal<\/strong> (dentro del sistema nervioso central) o a una <strong>disfunci\u00f3n de la barrera hematoencef\u00e1lica<\/strong>.<\/p>\n\n\n\n<p>Fue desarrollado por Helmut Reiber y se basa en el an\u00e1lisis cuantitativo de dos cocientes:<\/p>\n\n\n\n<ul class=\"wp-block-list\">\n<li><strong>QIgG<\/strong>: Cociente de IgG = [IgG_LCR] \/ [IgG_suero]<\/li>\n\n\n\n<li><strong>QAlb<\/strong>: Cociente de alb\u00famina = [Alb\u00famina_LCR] \/ [Alb\u00famina_suero]<br>(este \u00faltimo es un indicador indirecto de la integridad de la barrera hematoencef\u00e1lica).<\/li>\n<\/ul>\n\n\n\n<hr class=\"wp-block-separator has-alpha-channel-opacity\"\/>\n\n\n\n<h3 class=\"wp-block-heading\">\ud83e\udde0 \u00bfQu\u00e9 representa el gr\u00e1fico?<\/h3>\n\n\n\n<p>El eje X muestra <strong>QAlb<\/strong> (grado de disfunci\u00f3n de la barrera hematoencef\u00e1lica), y el eje Y muestra <strong>QIgG<\/strong> (cantidad relativa de IgG en el LCR). En el gr\u00e1fico se trazan tres zonas:<\/p>\n\n\n\n<ol class=\"wp-block-list\">\n<li>\ud83d\udd39 <strong>Zona Normal<\/strong>:\n<ul class=\"wp-block-list\">\n<li>Valores de QIgG y QAlb dentro del rango fisiol\u00f3gico.<\/li>\n\n\n\n<li>No hay evidencia de s\u00edntesis intratecal ni disfunci\u00f3n de barrera.<\/li>\n<\/ul>\n<\/li>\n\n\n\n<li>\ud83d\udfe6 <strong>Zona de disfunci\u00f3n de barrera<\/strong>:\n<ul class=\"wp-block-list\">\n<li>Aumento paralelo de IgG y alb\u00famina.<\/li>\n\n\n\n<li>Se interpreta como filtraci\u00f3n pasiva desde el suero por alteraci\u00f3n de la barrera hematoencef\u00e1lica.<\/li>\n<\/ul>\n<\/li>\n\n\n\n<li>\ud83d\udfe5 <strong>Zona de s\u00edntesis intratecal<\/strong>:\n<ul class=\"wp-block-list\">\n<li>QIgG est\u00e1 <strong>elevado fuera de proporci\u00f3n<\/strong> respecto a QAlb.<\/li>\n\n\n\n<li>Esto indica producci\u00f3n local de inmunoglobulinas dentro del sistema nervioso central, como ocurre en <strong>esclerosis m\u00faltiple<\/strong>, infecciones cr\u00f3nicas del SNC, etc.<\/li>\n<\/ul>\n<\/li>\n<\/ol>\n\n\n\n<hr class=\"wp-block-separator has-alpha-channel-opacity\"\/>\n\n\n\n<h3 class=\"wp-block-heading\">\ud83e\uddea \u00bfPara qu\u00e9 se usa?<\/h3>\n\n\n\n<p>El Diagrama de Reiber es \u00fatil para:<\/p>\n\n\n\n<ul class=\"wp-block-list\">\n<li>Diagnosticar o confirmar enfermedades con <strong>s\u00edntesis intratecal de IgG<\/strong> (como la esclerosis m\u00faltiple, neuros\u00edfilis, meningitis tuberculosa).<\/li>\n\n\n\n<li>Distinguir si una hipergammaglobulinorraquia se debe a <strong>s\u00edntesis intratecal<\/strong> o <strong>a una alteraci\u00f3n de la barrera<\/strong>.<\/li>\n\n\n\n<li>Evaluar si una alteraci\u00f3n de IgG en el LCR tiene origen <strong>sist\u00e9mico o neurol\u00f3gico<\/strong>.<\/li>\n<\/ul>\n\n\n\n<p>Tambi\u00e9n puede aplicarse al an\u00e1lisis de <strong>IgA<\/strong> e <strong>IgM<\/strong>, ajustando el diagrama correspondiente, lo cual es \u00fatil en ciertas enfermedades infecciosas o inflamatorias.<\/p>\n\n\n\n<figure class=\"wp-block-image size-full\"><img fetchpriority=\"high\" decoding=\"async\" width=\"1024\" height=\"1024\" src=\"https:\/\/neuropediatoolkit.org\/wp-content\/uploads\/2025\/06\/ChatGPT-Image-19-jun-2025-11_01_18-1.png\" alt=\"\" class=\"wp-image-7901\" srcset=\"https:\/\/neuropediatoolkit.org\/wp-content\/uploads\/2025\/06\/ChatGPT-Image-19-jun-2025-11_01_18-1.png 1024w, https:\/\/neuropediatoolkit.org\/wp-content\/uploads\/2025\/06\/ChatGPT-Image-19-jun-2025-11_01_18-1-300x300.png 300w, https:\/\/neuropediatoolkit.org\/wp-content\/uploads\/2025\/06\/ChatGPT-Image-19-jun-2025-11_01_18-1-150x150.png 150w, https:\/\/neuropediatoolkit.org\/wp-content\/uploads\/2025\/06\/ChatGPT-Image-19-jun-2025-11_01_18-1-768x768.png 768w, https:\/\/neuropediatoolkit.org\/wp-content\/uploads\/2025\/06\/ChatGPT-Image-19-jun-2025-11_01_18-1-12x12.png 12w\" sizes=\"(max-width: 1024px) 100vw, 1024px\" \/><\/figure>\n\n\n\n<p><\/p>\n","protected":false},"excerpt":{"rendered":"<p>The Reiber Diagram is a graphic tool designed to analyze the behavior of immunoglobulins (IgG, IgA or IgM) in the cerebrospinal fluid (CSF) and distinguish whether their presence is due to intrathecal synthesis (within the central nervous system) or to a dysfunction of the blood-brain barrier. It was developed by Helmut Reiber and\u2026 <\/p>\n<p class=\"link-more\"><a href=\"https:\/\/neuropediatoolkit.org\/en\/diagrama-de-reiber\/\" class=\"more-link\">Continue reading<span class=\"screen-reader-text\"> \u00abReiber diagram\u00bb<\/span><\/a><\/p>","protected":false},"author":1,"featured_media":7901,"comment_status":"closed","ping_status":"closed","sticky":false,"template":"","format":"standard","meta":{"_themeisle_gutenberg_block_has_review":false,"footnotes":""},"categories":[53],"tags":[],"class_list":["post-7896","post","type-post","status-publish","format-standard","has-post-thumbnail","hentry","category-neuroinflamatorias","entry"],"_links":{"self":[{"href":"https:\/\/neuropediatoolkit.org\/en\/wp-json\/wp\/v2\/posts\/7896","targetHints":{"allow":["GET"]}}],"collection":[{"href":"https:\/\/neuropediatoolkit.org\/en\/wp-json\/wp\/v2\/posts"}],"about":[{"href":"https:\/\/neuropediatoolkit.org\/en\/wp-json\/wp\/v2\/types\/post"}],"author":[{"embeddable":true,"href":"https:\/\/neuropediatoolkit.org\/en\/wp-json\/wp\/v2\/users\/1"}],"replies":[{"embeddable":true,"href":"https:\/\/neuropediatoolkit.org\/en\/wp-json\/wp\/v2\/comments?post=7896"}],"version-history":[{"count":2,"href":"https:\/\/neuropediatoolkit.org\/en\/wp-json\/wp\/v2\/posts\/7896\/revisions"}],"predecessor-version":[{"id":7902,"href":"https:\/\/neuropediatoolkit.org\/en\/wp-json\/wp\/v2\/posts\/7896\/revisions\/7902"}],"wp:featuredmedia":[{"embeddable":true,"href":"https:\/\/neuropediatoolkit.org\/en\/wp-json\/wp\/v2\/media\/7901"}],"wp:attachment":[{"href":"https:\/\/neuropediatoolkit.org\/en\/wp-json\/wp\/v2\/media?parent=7896"}],"wp:term":[{"taxonomy":"category","embeddable":true,"href":"https:\/\/neuropediatoolkit.org\/en\/wp-json\/wp\/v2\/categories?post=7896"},{"taxonomy":"post_tag","embeddable":true,"href":"https:\/\/neuropediatoolkit.org\/en\/wp-json\/wp\/v2\/tags?post=7896"}],"curies":[{"name":"wp","href":"https:\/\/api.w.org\/{rel}","templated":true}]}}