@precisa-saude/fhir 0.10.0 → 0.11.0

package/README.md

@@ -1,6 +1,6 @@
 # @precisa-saude/fhir
 
-Tipos FHIR R4, 180+ definições de biomarcadores com códigos LOINC, faixas de referência (SBPC/ML, SBC, SBD), conversores e importadores para o contexto clínico brasileiro.
+Tipos FHIR R4, 200+ definições de biomarcadores com códigos LOINC, faixas de referência (SBPC/ML, SBC, SBD), conversores e importadores para o contexto clínico brasileiro.
 
 ## Instalação
 
@@ -49,7 +49,7 @@ import { getDefinitionByCode, getAllDefinitions } from '@precisa-saude/fhir';
 const def = getDefinitionByCode('HDL');
 // { code: 'HDL', loinc: '2085-9', names: { pt: [...], en: [...] }, ... }
 
-const all = getAllDefinitions(); // 180+ definições
+const all = getAllDefinitions(); // 200+ definições
 ```
 
 ## Sub-path imports
@@ -67,14 +67,32 @@ import { validateFHIRObservation } from '@precisa-saude/fhir/validators';
 
 ## Módulos
 
-| Sub-path            | Descrição                                                          |
-| ------------------- | ------------------------------------------------------------------ |
-| `/biomarkers`       | 180+ definições com códigos LOINC, nomes pt/en, categorias         |
-| `/reference-ranges` | Faixas de referência por sexo/idade (SBPC/ML, SBC, SBD, OMS)       |
-| `/converter`        | Converte dados laboratoriais para FHIR R4 Bundle                   |
-| `/importer`         | Importa FHIR Bundle de volta para estruturas internas              |
-| `/units`            | Mapeamento de unidades, conversão para UCUM                        |
-| `/validators`       | Validação de recursos FHIR (DiagnosticReport, Observation, Bundle) |
+| Sub-path            | Descrição                                                             |
+| ------------------- | --------------------------------------------------------------------- |
+| `/biomarkers`       | 200+ definições com códigos LOINC, nomes pt/en, sub-categorias        |
+| `/category-groups`  | Agrupamento de 10 categorias clínicas top-level sobre as 20 sub       |
+| `/reference-ranges` | Faixas de referência por sexo/idade/gestação (SBPC/ML, SBC, SBD, OMS) |
+| `/converter`        | Converte dados laboratoriais para FHIR R4 Bundle                      |
+| `/importer`         | Importa FHIR Bundle de volta para estruturas internas                 |
+| `/units`            | Mapeamento de unidades, conversão para UCUM                           |
+| `/validators`       | Validação de recursos FHIR (DiagnosticReport, Observation, Bundle)    |
+
+## Escopo das faixas de referência
+
+As faixas em `/reference-ranges` são **validadas para adultos (≥18 anos)**. Variantes pediátricas não estão incluídas — consumidores que atendem populações pediátricas devem adicionar suas próprias faixas ou buscar fontes específicas (SBP, protocolos neonatais).
+
+Variantes gestacionais estão disponíveis para `TSH`, `Hgb`, `Ferritin`, `Creatinine` e `Glucose`. Para usar, passe `pregnant: true` e, quando conhecido, `pregnancyTrimester` no `ReferenceRangeContext`:
+
+```ts
+const range = getReferenceRange('TSH', {
+  biologicalSex: 'F',
+  pregnant: true,
+  pregnancyTrimester: 1,
+});
+// → { max: 2.5, min: 0.1, ... } (alvo ATA 2017 para 1º trimestre)
+```
+
+O metadado opcional `fastingRequired` em `BiomarkerReferenceRange` indica se a amostra exige jejum estrito (ex.: `Glucose`, `Insulin`, `HOMA_IR`) ou se o jejum é preferido mas não obrigatório (ex.: `Triglycerides`, que aceita dosagem não-jejum por SBC 2017/2025).
 
 ## Aviso médico
 

package/dist/biomarkers.cjs

@@ -30,7 +30,7 @@
 
 
 
-var _chunk2EVQ2ESBcjs = require('./chunk-2EVQ2ESB.cjs');
+var _chunkEW5GLFSCcjs = require('./chunk-EW5GLFSC.cjs');
 
 
 
@@ -63,5 +63,5 @@ var _chunk2EVQ2ESBcjs = require('./chunk-2EVQ2ESB.cjs');
 
 
 
-exports.BIOMARKER_DEFINITIONS = _chunk2EVQ2ESBcjs.BIOMARKER_DEFINITIONS; exports.CAC_INDICATOR_CODES = _chunk2EVQ2ESBcjs.CAC_INDICATOR_CODES; exports.DEXA_CATEGORIES = _chunk2EVQ2ESBcjs.DEXA_CATEGORIES; exports.DEXA_INDICATOR_CODES = _chunk2EVQ2ESBcjs.DEXA_INDICATOR_CODES; exports.codeToLoinc = _chunk2EVQ2ESBcjs.codeToLoinc; exports.filterVisibleBiomarkers = _chunk2EVQ2ESBcjs.filterVisibleBiomarkers; exports.findCodeByName = _chunk2EVQ2ESBcjs.findCodeByName; exports.generateCacFullReference = _chunk2EVQ2ESBcjs.generateCacFullReference; exports.generateDexaFullReference = _chunk2EVQ2ESBcjs.generateDexaFullReference; exports.generateFilteredLLMReference = _chunk2EVQ2ESBcjs.generateFilteredLLMReference; exports.generateLLMReference = _chunk2EVQ2ESBcjs.generateLLMReference; exports.getAllCodes = _chunk2EVQ2ESBcjs.getAllCodes; exports.getAllDefinitions = _chunk2EVQ2ESBcjs.getAllDefinitions; exports.getAllLoincCodes = _chunk2EVQ2ESBcjs.getAllLoincCodes; exports.getAllSearchPatterns = _chunk2EVQ2ESBcjs.getAllSearchPatterns; exports.getBiomarkersByCategory = _chunk2EVQ2ESBcjs.getBiomarkersByCategory; exports.getBiomarkersForCategories = _chunk2EVQ2ESBcjs.getBiomarkersForCategories; exports.getDefinitionByCode = _chunk2EVQ2ESBcjs.getDefinitionByCode; exports.getDefinitionByLoinc = _chunk2EVQ2ESBcjs.getDefinitionByLoinc; exports.getDefinitionsBySex = _chunk2EVQ2ESBcjs.getDefinitionsBySex; exports.getSexForCode = _chunk2EVQ2ESBcjs.getSexForCode; exports.getVisibleDefinitions = _chunk2EVQ2ESBcjs.getVisibleDefinitions; exports.isBiomarkerVisible = _chunk2EVQ2ESBcjs.isBiomarkerVisible; exports.isCacDocument = _chunk2EVQ2ESBcjs.isCacDocument; exports.isDexaDocument = _chunk2EVQ2ESBcjs.isDexaDocument; exports.isValidCode = _chunk2EVQ2ESBcjs.isValidCode; exports.isValidLoinc = _chunk2EVQ2ESBcjs.isValidLoinc; exports.loincToCode = _chunk2EVQ2ESBcjs.loincToCode; exports.normalizeCode = _chunk2EVQ2ESBcjs.normalizeCode; exports.toBiomarkerTests = _chunk2EVQ2ESBcjs.toBiomarkerTests; exports.validateLoincNameMatch = _chunk2EVQ2ESBcjs.validateLoincNameMatch;
+exports.BIOMARKER_DEFINITIONS = _chunkEW5GLFSCcjs.BIOMARKER_DEFINITIONS; exports.CAC_INDICATOR_CODES = _chunkEW5GLFSCcjs.CAC_INDICATOR_CODES; exports.DEXA_CATEGORIES = _chunkEW5GLFSCcjs.DEXA_CATEGORIES; exports.DEXA_INDICATOR_CODES = _chunkEW5GLFSCcjs.DEXA_INDICATOR_CODES; exports.codeToLoinc = _chunkEW5GLFSCcjs.codeToLoinc; exports.filterVisibleBiomarkers = _chunkEW5GLFSCcjs.filterVisibleBiomarkers; exports.findCodeByName = _chunkEW5GLFSCcjs.findCodeByName; exports.generateCacFullReference = _chunkEW5GLFSCcjs.generateCacFullReference; exports.generateDexaFullReference = _chunkEW5GLFSCcjs.generateDexaFullReference; exports.generateFilteredLLMReference = _chunkEW5GLFSCcjs.generateFilteredLLMReference; exports.generateLLMReference = _chunkEW5GLFSCcjs.generateLLMReference; exports.getAllCodes = _chunkEW5GLFSCcjs.getAllCodes; exports.getAllDefinitions = _chunkEW5GLFSCcjs.getAllDefinitions; exports.getAllLoincCodes = _chunkEW5GLFSCcjs.getAllLoincCodes; exports.getAllSearchPatterns = _chunkEW5GLFSCcjs.getAllSearchPatterns; exports.getBiomarkersByCategory = _chunkEW5GLFSCcjs.getBiomarkersByCategory; exports.getBiomarkersForCategories = _chunkEW5GLFSCcjs.getBiomarkersForCategories; exports.getDefinitionByCode = _chunkEW5GLFSCcjs.getDefinitionByCode; exports.getDefinitionByLoinc = _chunkEW5GLFSCcjs.getDefinitionByLoinc; exports.getDefinitionsBySex = _chunkEW5GLFSCcjs.getDefinitionsBySex; exports.getSexForCode = _chunkEW5GLFSCcjs.getSexForCode; exports.getVisibleDefinitions = _chunkEW5GLFSCcjs.getVisibleDefinitions; exports.isBiomarkerVisible = _chunkEW5GLFSCcjs.isBiomarkerVisible; exports.isCacDocument = _chunkEW5GLFSCcjs.isCacDocument; exports.isDexaDocument = _chunkEW5GLFSCcjs.isDexaDocument; exports.isValidCode = _chunkEW5GLFSCcjs.isValidCode; exports.isValidLoinc = _chunkEW5GLFSCcjs.isValidLoinc; exports.loincToCode = _chunkEW5GLFSCcjs.loincToCode; exports.normalizeCode = _chunkEW5GLFSCcjs.normalizeCode; exports.toBiomarkerTests = _chunkEW5GLFSCcjs.toBiomarkerTests; exports.validateLoincNameMatch = _chunkEW5GLFSCcjs.validateLoincNameMatch;
 //# sourceMappingURL=biomarkers.cjs.map

package/dist/biomarkers.js

@@ -30,7 +30,7 @@ import {
   normalizeCode,
   toBiomarkerTests,
   validateLoincNameMatch
-} from "./chunk-I6H35QXI.js";
+} from "./chunk-ICSMWCVT.js";
 export {
   BIOMARKER_DEFINITIONS,
   CAC_INDICATOR_CODES,

package/dist/{chunk-S6VJHXJF.js → chunk-4YQOKZX7.js}

@@ -1,7 +1,7 @@
 import {
   getDefinitionByLoinc,
   loincToCode
-} from "./chunk-I6H35QXI.js";
+} from "./chunk-ICSMWCVT.js";
 import {
   validateFHIRImportBundle
 } from "./chunk-N3ZCOLG2.js";
@@ -150,4 +150,4 @@ export {
   mapFHIRObservationToInternal,
   processImportBundle
 };
-//# sourceMappingURL=chunk-S6VJHXJF.js.map
+//# sourceMappingURL=chunk-4YQOKZX7.js.map

package/dist/{chunk-2EVQ2ESB.cjs → chunk-EW5GLFSC.cjs}

@@ -2382,6 +2382,210 @@ var BIOMARKER_DEFINITIONS = [
       pt: ["Z-Score Corpo Total", "Z-Score", "Escore Z", "Z-Score DMO", "Z-Score Densidade \xD3ssea"]
     },
     unit: "score"
+  },
+  // ============================================================================
+  // CARDIOVASCULAR MARKERS — Insuficiência cardíaca e dano miocárdico
+  // ============================================================================
+  {
+    category: "coracao",
+    code: "NTproBNP",
+    loinc: "33762-6",
+    names: {
+      en: ["NT-proBNP", "N-Terminal pro B-Type Natriuretic Peptide", "NT-pro-BNP"],
+      pt: ["NT-proBNP", "Pept\xEDdeo Natriur\xE9tico Tipo B N-Terminal", "Pr\xF3-BNP N-Terminal"]
+    },
+    unit: "pg/mL"
+  },
+  {
+    category: "coracao",
+    code: "BNP",
+    loinc: "30934-4",
+    names: {
+      en: ["BNP", "B-Type Natriuretic Peptide", "Brain Natriuretic Peptide"],
+      pt: ["BNP", "Pept\xEDdeo Natriur\xE9tico Tipo B", "Pept\xEDdeo Natriur\xE9tico Cerebral"]
+    },
+    unit: "pg/mL"
+  },
+  {
+    category: "coracao",
+    code: "TroponinI",
+    loinc: "49563-0",
+    names: {
+      en: ["Troponin I", "cTnI", "Cardiac Troponin I", "hs-TnI", "High-Sensitivity Troponin I"],
+      pt: ["Troponina I", "cTnI", "Troponina I Card\xEDaca", "Troponina I Ultrassens\xEDvel"]
+    },
+    unit: "ng/mL"
+  },
+  {
+    category: "coracao",
+    code: "TroponinT",
+    loinc: "6598-7",
+    names: {
+      en: ["Troponin T", "cTnT", "Cardiac Troponin T", "hs-TnT", "High-Sensitivity Troponin T"],
+      pt: ["Troponina T", "cTnT", "Troponina T Card\xEDaca", "Troponina T Ultrassens\xEDvel"]
+    },
+    unit: "ng/mL"
+  },
+  // ============================================================================
+  // COAGULATION — Coagulação
+  // ============================================================================
+  {
+    category: "sangue",
+    code: "DDimer",
+    loinc: "48066-5",
+    names: {
+      en: ["D-Dimer", "D Dimer", "Fibrin D-Dimer"],
+      pt: ["D\xEDmero-D", "D\xEDmero D", "D-D\xEDmero"]
+    },
+    unit: "ng/mL"
+  },
+  {
+    category: "sangue",
+    code: "Fibrinogen",
+    loinc: "3255-7",
+    names: {
+      en: ["Fibrinogen", "Fibrinogen Activity"],
+      pt: ["Fibrinog\xEAnio", "Atividade do Fibrinog\xEAnio"]
+    },
+    unit: "mg/dL"
+  },
+  // ============================================================================
+  // HEMATOLOGY — Hematologia adicional
+  // ============================================================================
+  {
+    category: "figado",
+    code: "LDH",
+    loinc: "2532-0",
+    names: {
+      en: ["Lactate Dehydrogenase", "LDH", "LD"],
+      pt: ["Desidrogenase L\xE1tica", "DHL", "LDH", "Lactato Desidrogenase"]
+    },
+    unit: "U/L"
+  },
+  // ============================================================================
+  // ENDOCRINE — Eixo cálcio/fósforo
+  // ============================================================================
+  {
+    category: "hormonios",
+    code: "PTH",
+    loinc: "2731-8",
+    names: {
+      en: ["Parathyroid Hormone", "PTH", "Intact PTH"],
+      pt: ["Paratorm\xF4nio", "PTH", "Horm\xF4nio da Paratireoide", "PTH Intacto"]
+    },
+    unit: "pg/mL"
+  },
+  // ============================================================================
+  // IMMUNOLOGY — Complemento e imunoglobulinas
+  // ============================================================================
+  {
+    category: "autoimunidade",
+    code: "IgM",
+    loinc: "2472-9",
+    names: {
+      en: ["Immunoglobulin M", "IgM", "Total IgM"],
+      pt: ["Imunoglobulina M", "IgM", "IgM Total"]
+    },
+    unit: "mg/dL"
+  },
+  {
+    category: "autoimunidade",
+    code: "C3",
+    loinc: "4485-3",
+    names: {
+      en: ["Complement C3", "C3"],
+      pt: ["Complemento C3", "C3", "Fra\xE7\xE3o C3 do Complemento"]
+    },
+    unit: "mg/dL"
+  },
+  {
+    category: "autoimunidade",
+    code: "C4",
+    loinc: "4498-6",
+    names: {
+      en: ["Complement C4", "C4"],
+      pt: ["Complemento C4", "C4", "Fra\xE7\xE3o C4 do Complemento"]
+    },
+    unit: "mg/dL"
+  },
+  // ============================================================================
+  // TUMOR MARKERS — Marcadores tumorais adicionais
+  // ============================================================================
+  {
+    category: "marcadores-tumorais",
+    code: "CA199",
+    loinc: "24108-3",
+    names: {
+      en: ["CA 19-9", "Carbohydrate Antigen 19-9", "CA19-9"],
+      pt: ["CA 19-9", "Ant\xEDgeno Carboidrato 19-9", "CA19-9"]
+    },
+    unit: "U/mL"
+  },
+  {
+    category: "marcadores-tumorais",
+    code: "CA153",
+    loinc: "6875-9",
+    names: {
+      en: ["CA 15-3", "Cancer Antigen 15-3", "CA15-3"],
+      pt: ["CA 15-3", "Ant\xEDgeno C\xE2ncer 15-3", "CA15-3"]
+    },
+    sex: "female",
+    unit: "U/mL"
+  },
+  {
+    category: ["saude-feminina", "marcadores-tumorais"],
+    code: "BetaHCG",
+    loinc: "19080-1",
+    names: {
+      en: ["Beta-hCG", "Beta Human Chorionic Gonadotropin", "\u03B2-hCG Quantitative", "hCG"],
+      pt: [
+        "Beta-hCG",
+        "Beta Gonadotrofina Cori\xF4nica Humana",
+        "\u03B2-hCG Quantitativo",
+        "hCG",
+        "Gonadotrofina Cori\xF4nica"
+      ]
+    },
+    unit: "mIU/mL"
+  },
+  // ============================================================================
+  // RENAL — Filtração glomerular alternativa
+  // ============================================================================
+  {
+    category: "rins",
+    code: "CystatinC",
+    loinc: "33863-2",
+    names: {
+      en: ["Cystatin C", "Cystatin-C"],
+      pt: ["Cistatina C", "Cistatina-C"]
+    },
+    unit: "mg/L"
+  },
+  // ============================================================================
+  // NUTRIENTS — Oligoelementos adicionais
+  // ============================================================================
+  {
+    category: "nutrientes",
+    code: "Selenium",
+    loinc: "5697-7",
+    names: {
+      en: ["Selenium", "Se"],
+      pt: ["Sel\xEAnio", "Se"]
+    },
+    unit: "\xB5g/L"
+  },
+  // ============================================================================
+  // METABOLIC — Cetonas séricas
+  // ============================================================================
+  {
+    category: "pancreas",
+    code: "BetaHydroxybutyrate",
+    loinc: "53060-0",
+    names: {
+      en: ["Beta-Hydroxybutyrate", "\u03B2-Hydroxybutyrate", "BHB", "Ketone Bodies"],
+      pt: ["Beta-Hidroxibutirato", "\u03B2-Hidroxibutirato", "BHB", "Corpos Cet\xF4nicos"]
+    },
+    unit: "mmol/L"
   }
 ];
 var loincToCodeMap = /* @__PURE__ */ new Map();
@@ -2689,4 +2893,4 @@ function getBiomarkersForCategories(categories, options) {
 
 
 exports.BIOMARKER_DEFINITIONS = BIOMARKER_DEFINITIONS; exports.loincToCode = loincToCode; exports.codeToLoinc = codeToLoinc; exports.isValidLoinc = isValidLoinc; exports.isValidCode = isValidCode; exports.normalizeCode = normalizeCode; exports.getSexForCode = getSexForCode; exports.getDefinitionsBySex = getDefinitionsBySex; exports.getDefinitionByCode = getDefinitionByCode; exports.getDefinitionByLoinc = getDefinitionByLoinc; exports.getAllDefinitions = getAllDefinitions; exports.getVisibleDefinitions = getVisibleDefinitions; exports.getAllCodes = getAllCodes; exports.getAllLoincCodes = getAllLoincCodes; exports.generateLLMReference = generateLLMReference; exports.toBiomarkerTests = toBiomarkerTests; exports.getAllSearchPatterns = getAllSearchPatterns; exports.generateFilteredLLMReference = generateFilteredLLMReference; exports.DEXA_INDICATOR_CODES = DEXA_INDICATOR_CODES; exports.DEXA_CATEGORIES = DEXA_CATEGORIES; exports.generateDexaFullReference = generateDexaFullReference; exports.isDexaDocument = isDexaDocument; exports.CAC_INDICATOR_CODES = CAC_INDICATOR_CODES; exports.generateCacFullReference = generateCacFullReference; exports.isCacDocument = isCacDocument; exports.findCodeByName = findCodeByName; exports.validateLoincNameMatch = validateLoincNameMatch; exports.isBiomarkerVisible = isBiomarkerVisible; exports.filterVisibleBiomarkers = filterVisibleBiomarkers; exports.getBiomarkersByCategory = getBiomarkersByCategory; exports.getBiomarkersForCategories = getBiomarkersForCategories;
-//# sourceMappingURL=chunk-2EVQ2ESB.cjs.map
+//# sourceMappingURL=chunk-EW5GLFSC.cjs.map