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Vol. 15. Issue 2.
Pages 313-318 (March - April 2009)
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Vol. 15. Issue 2.
Pages 313-318 (March - April 2009)
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Alveolite alérgica extrínseca com expressão imunológica atípica
Extrinsic allergic alveolitis with an atypical immune expression
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Teresa Costa1, Cidália Rodrigues1, Ana Arrobas2, Jorge Pires3
1 Interna do Complementar de Pneumologia
2 Assistente Hospitalar Graduada de Pneumologia
3 Serviço de Pneumologia, Centro Hospitalar de Coimbra, Quinta dos Vales, São Martinho do Bispo, 3046-853 Coimbra.
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Resumo

A alveolite alérgica extrínseca e a sarcoidose são ambas doenças granulomatosas pulmonares que se caracterizam pela presença de granulomas não necrotizantes. Ambas apresentam alterações típicas no lavado broncoalveolar, com relações CD4/CD8 opostas. No entanto, a sarcoidose não apresenta hoje em dia factores etiológicos bem definidos, como a alveolite alérgica extrínseca. As autoras apresentam dois casos clínicos com curso clínico, imagiológico, funcional e imunológico semelhante, embora com confirmação histopatológica não concordante com as alterações do LBA e com a particularidade de pertencerem a dois elementos da mesma família, convivente, e de terem surgido com poucas semanas de intervalo.

Palavras-chave:
Alveolite alérgica extrínseca
pneumonia de hipersensibilidade
sarcoidose
Abstract

Extrinsic allergic alveolitis and sarcoidosis are two granulomatosis of the lung characterized by non-necrotizing granuloma. Both have typical bronchoalveolar lavage immunology, with opposite CD4/CD8 relation. However, sarcoidosis does not have such well defined etiology as extrinsic allergic alveolitis.

The authors present two cases with similar clinical course, imagiology, lung function and immunology, although they both had an histology that was not concordant with the bronchoalveolar lavage, and with the peculiarity of being two elements of the same family, co-inhabitants and with a clinical presentation only a few weeks apart.

Key-words:
Extrinsic allergic alveolitis
hypersensitivity pneumonitis
sarcoidosis
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Bibliografia
[1.]
D.R. Moller.
Systemic sarcoidosis.
Fishman's pulmonary diseases and disorders, Fourth Edition, pp. 1125-1142
[2.]
R.I. Enelow.
Hypersensitivity pneumonitis.
Fishman's pulmonary diseases and disorders, Fourth Edition, pp. 1161-1172
[3.]
E. Bagatin, C.A.C. Pereira, J.B. Afiune.
Doenças granulomatosas ocupacionais.
J Bras Pneumol, 32 (2006), pp. S69-S84
[4.]
L.S. Newman, Y.S. Wasfi.
Sarcoidosis.
pp. 128-138
[5.]
Y. Lacasse, Y. Cormier.
Hypersensitivity pneumonitis.
Orph J Rare Dis, 1 (2006), pp. 25
[6.]
A.K. Gerke, G. Hunninghake.
The Immunology of Sarcoidosis.
R.P.BaughmanM.Drent. Sarcoidosis. Clin Chest Med, 29 (2008), pp. 379-390
[7.]
U. Costabel, G.W. Hunninghake.
ATS/ERS/WASOG Statement on sarcoidosis.
Am J Respir Crit Care Med, 160 (1999), pp. 736-755
[8.]
C. Vogelmeier.
Hypersensitivity pneumonitis.
pp. 139-147
Copyright © 2009. Sociedade Portuguesa de Pneumologia
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