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Pneumonia organizativa – Experiência da consulta de um hospital central
Organising pneumonia – the experience of an outpatient clinic of a central hospital
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Aguiar, M. Felizardo, A.C. Mendes, D. Moniz, R. Sotto-Mayor, A. Bugalho de Almeida" "autores" => array:6 [ 0 => array:4 [ "nombre" => "M." "apellidos" => "Aguiar" "email" => array:1 [ 0 => "m_aguiar@netcabo.pt" ] "referencia" => array:2 [ 0 => array:2 [ "etiqueta" => "<span class="elsevierStyleSup">1</span>" "identificador" => "af0005" ] 1 => array:2 [ "etiqueta" => "*" "identificador" => "cr0005" ] ] ] 1 => array:3 [ "nombre" => "M." "apellidos" => "Felizardo" "referencia" => array:1 [ 0 => array:2 [ "etiqueta" => "<span class="elsevierStyleSup">1</span>" "identificador" => "af0005" ] ] ] 2 => array:3 [ "nombre" => "A.C." "apellidos" => "Mendes" "referencia" => array:1 [ 0 => array:2 [ "etiqueta" => "<span class="elsevierStyleSup">2</span>" "identificador" => "af0010" ] ] ] 3 => array:3 [ "nombre" => "D." 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Bugalho" "apellidos" => "de Almeida" "referencia" => array:1 [ 0 => array:2 [ "etiqueta" => "<span class="elsevierStyleSup">4</span>" "identificador" => "af0020" ] ] ] ] "afiliaciones" => array:4 [ 0 => array:3 [ "entidad" => "Interna do Complementar de Pneumologia/Resident, Pulmonology" "etiqueta" => "1" "identificador" => "af0005" ] 1 => array:3 [ "entidad" => "Assistente Hospitalar Graduada de Pneumologia/Consultant, Pulmonology Specialist" "etiqueta" => "2" "identificador" => "af0010" ] 2 => array:3 [ "entidad" => "Chefe de Serviço de Pneumologia/Head, Pulmonology Unit" "etiqueta" => "3" "identificador" => "af0015" ] 3 => array:3 [ "entidad" => "Director de Serviço do Serviço de Pneumologia I/Head, Pulmonology Unit I" "etiqueta" => "4" "identificador" => "af0020" ] ] "correspondencia" => array:1 [ 0 => array:3 [ "identificador" => "cr0005" "etiqueta" => "*" "correspondencia" => "<span class="elsevierStyleBold">Correspondência/<span class="elsevierStyleItalic">Correspondence to:</span></span> Margarida Aguiar, Serviço de Pneumologia I, Hospital de Santa Maria, CHLN, Av. Egas Moniz, 1500 Lisboa." ] ] ] ] "titulosAlternativos" => array:1 [ "en" => array:1 [ "titulo" => "Organising pneumonia – the experience of an outpatient clinic of a central hospital" ] ] "pdfFichero" => "main.pdf" "tienePdf" => true "fechaRecibido" => "2009-07-06" "fechaAceptado" => "2009-10-01" "PalabrasClave" => array:2 [ "pt" => array:1 [ 0 => array:4 [ "clase" => "keyword" "titulo" => "Palavras-chave" "identificador" => "xpalclavsec570157" "palabras" => array:2 [ 0 => "Pneumonia organizativa criptogénica" 1 => "pneumonia organizativa secundária" ] ] ] "en" => array:1 [ 0 => array:4 [ "clase" => "keyword" "titulo" => "Key-words" "identificador" => "xpalclavsec570156" "palabras" => array:2 [ 0 => "Cryptogenic organising pneumonia" 1 => "secondary organising pneumonia" ] ] ] ] "tieneResumen" => true "resumen" => array:2 [ "pt" => array:2 [ "titulo" => "Resumo" "resumen" => "<span id="as0005" class="elsevierStyleSection elsevierViewall"><p id="sp0005" class="elsevierStyleSimplePara elsevierViewall"><span class="elsevierStyleBold">Introdução:</span> A pneumonia organizativa, anteriormente designada como BOOP, é uma entidade individualizada desde há duas décadas, que apresenta características clínicas, radiológicas e critérios histológicos de diagnóstico específicos. Caracterizámos os doentes com pneumonia organizativa seguidos em consulta de Pneumologia/Doenças do Interstício do nosso hospital, no período de Janeiro de 1997 a Dezembro de 2006, e comparámos os resultados com os da literatura. <span class="elsevierStyleBold">Materiais e métodos:</span> Foram consultados retrospectivamente os processos dos doentes com o diagnóstico de pneumonia organizativa (OP) e avaliados os seguintes parâmetros: idade, sexo, clínica, características imagiológicas, tempo até ao diagnóstico, etiologia, alterações laboratoriais e histológicas, tratamento e recidivas. <span class="elsevierStyleBold">Resultados:</span> Foram estudados 13 doentes, 12 dos quais do sexo feminino (92%), idade média de apresentação 55,6 anos (+-15,3); 10 eram não fumadores e dois ex-fumadores. O tempo médio desde o início da sintomatologia até ao diagnóstico foi de 77,2 semanas (máximo 432 e mínimo 3 semanas) e o tempo médio do acompanhamento de 171,6 semanas (máximo 334 e mínimo 28 semanas). No grupo de OP primária (pneumonia organizativa criptogénica – COP) incluíram-se nove doentes e quatro no secundário (pneumonia organizativa secundária – SOP), sendo dois com artrite reumatóide (AR), um com dermatomiosite e um submetido a radioterapia por neoplasia da mama. Os principais sintomas na altura do diagnóstico foram fadiga (92%), tosse (85%), febre (65%), dispneia (54%), dor torácica (23%), perda ponderal (23%) e mialgias (17%). Laboratorialmente apresentavam velocidade de sedimentação média de 70<span class="elsevierStyleHsp" style=""></span>mm; (máximo de 127<span class="elsevierStyleHsp" style=""></span>mm e mínimo de 16<span class="elsevierStyleHsp" style=""></span>mm), proteína C reactiva elevada em oito doentes, e ausência de leucocitose. A radiografia de tórax e TC torácica mostravam doença bilateral em doze doentes (92%), imagem de consolidação com broncograma aéreo presente também em doze doentes, quatro dos quais com lesões migratórias. Quatro realizaram biópsia pulmonar transbrônquica, todas incaracterísticas, e oito fizeram biópsia pulmonar cirúrgica, quatro das quais diagnósticas de OP. Onze fizeram terapêutica com corticoterapia com uma duração média de 61,6 semanas (máximo 288 e mínimo 16). Dois doentes mantêm doses baixas de corticoterapia, um pela sua patologia de base e outro por múltiplas recidivas. Houve recidiva em quatro doentes (30,8%), um dos quais por cinco vezes. <span class="elsevierStyleBold">Discussão e conclusão:</span> De salientar, nesta série, a elevada incidência desta patologia no sexo feminino. É preconizada a confirmação histológica, mas, na presente série, foi possível estabelecer o diagnóstico em nove doentes, com base apenas em parâmetros clínicos, imagiológicos e de resposta à terapêutica. O tempo médiode diagnóstico foi muito variável, o que sugere que a doença por vezes não é diagnosticada e os doentes são tratados como apresentando pneumonias ou outras doenças do interstício. A maioria apresentou uma evolução clínica favorável com recidiva francamente inferior à descrita na literatura. Perante quadros clínicos de “pneumonia arrastada” que não resolvem com antibioticoterapia em 3-4 semanas, impõe-se a realização de exames complementares subsequentes no sentido de despistar outras patologias, nomeadamente a pneumonia organizativa. Apenas em centros com experiência nesta área se deverá aceitar um diagnóstico exclusivamente com critérios clínicos e radiológicos.</p><p id="sp0015" class="elsevierStyleSimplePara elsevierViewall"><span class="elsevierStyleBold">Rev Port Pneumol 2010; XVI (3): 369-389</span></p></span>" ] "en" => array:2 [ "titulo" => "Abstract" "resumen" => "<span id="as0010" class="elsevierStyleSection elsevierViewall"><p id="sp0020" class="elsevierStyleSimplePara elsevierViewall"><span class="elsevierStyleBold">Aim:</span> to characterise outpatients of a Portuguese central hospital diagnosed with organising pneumonia (OP) and compare results with current literature. <span class="elsevierStyleBold">Methods:</span> medical processes with diagnosis of OP were retrospectively studied as to demographics, aetiology, clinical and radiological features, average time until and date of diagnosis, laboratory and histological changes, treatment and relapse. Results – thirteen patients with a mean follow-up of 171.6<span class="elsevierStyleHsp" style=""></span>weeks (max 334 and min 28 weeks) were evaluated. Nine of these patients (70%) had cryptogenic OP (COP) while 30% had secondary OP (SOP), two with rheumatoid arthritis, one with dermatomyositis and another undergoing radiotherapy for breast cancer. Mean age was 55.6 (+-15.3<span class="elsevierStyleHsp" style=""></span>years), 92% female, 77% were non-smokers. Average time until diagnosis was 77.2<span class="elsevierStyleHsp" style=""></span>weeks (min 3 and max 432 weeks). Symptoms at presentation were tiredness (92%), cough (85%), fever (65%), shortness of breath (54%), thoracic pain (23%) and weight loss (23%). At the time of diagnosis, the mean erythrocyte sedimentation rate was 70<span class="elsevierStyleHsp" style=""></span>mm (max 170<span class="elsevierStyleHsp" style=""></span>mm and min 16<span class="elsevierStyleHsp" style=""></span>mm). C-reactive protein level was increased in eight patients. Significant leucocytosis was absent. Chest X-ray and chest CT scan showed bilateral distribution in 12 patients (92%). Consolidation with an air bronchogram was present in 12 patients and in four (31%), consolidation was migratory. Four patients (30%) underwent transbronchial pulmonary biopsy, all uncharacteristic and eight patients surgical pulmonary biopsy, four showed histological confirmation of SOP. Corticosteroids were started in 11 patients and average treatment was 61.6<span class="elsevierStyleHsp" style=""></span>weeks (16-288 weeks). 15% (2/13) had spontaneous resolution. Four patients (31%) relapsed, one of them five times. Two patients are dependent on a low dose of corticosteroids, one due to underlying disease and another due to multiple relapses. Therapy of relapse was corticosteroids alone in minimum effective dosage or associated to azathioprine or ciclosporin. <span class="elsevierStyleBold">Discussion and conclusion:</span> such a high incidence in females (92%) may be explained by the limited sample of patients. In 70% of the patients diagnosis were established by clinical and radiology criteria. Mean time to diagnosis was very variable which suggests that in some cases the disease was not diagnosed and treated as another interstitial lung disease or as recurrent pneumonia. Most patients (53.8%) had a favourable clinical course after treatment with corticosteroids with a very low number of relapses (30.8%), much lower than described by other authors (60%). Only in experienced centres should the diagnosis of OP established by clinical and radiological criteria.</p><p id="sp0025" class="elsevierStyleSimplePara elsevierViewall"><span class="elsevierStyleBold">Rev Port Pneumol 2010; XVI (3): 369-389</span></p></span>" ] ] "lecturaRecomendada" => array:1 [ 0 => array:3 [ "vista" => "all" "titulo" => "<span class="elsevierStyleSectionTitle" id="st0025">Bibliografia/Bibliography</span>" "seccion" => array:1 [ 0 => array:2 [ "vista" => "all" "bibliografiaReferencia" => array:8 [ 0 => array:3 [ "identificador" => "bb0005" "etiqueta" => "1." "referencia" => array:1 [ 0 => array:2 [ "contribucion" => array:1 [ 0 => array:2 [ "titulo" => "Relapses in cryptogenic organizing pneumonia-characteristics of relapses in a series of 48 patients" "autores" => array:1 [ 0 => array:2 [ "etal" => true "autores" => array:6 [ 0 => "R. Lazor" 1 => "A. Vandevenne" 2 => "A. Pelletier" 3 => "P. Leclerc" 4 => "I. CourtFortune" 5 => "J.F. 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Costabel" 1 => "J. Guzmon" 2 => "H. Tescler" ] ] ] ] ] "host" => array:1 [ 0 => array:1 [ "Revista" => array:7 [ "tituloSerie" => "Thorax" "fecha" => "1995" "volumen" => "50" "numero" => "1" "paginaInicial" => "S59" "paginaFinal" => "S64" "link" => array:1 [ 0 => array:2 [ "url" => "https://www.ncbi.nlm.nih.gov/pubmed/7570467" "web" => "Medline" ] ] ] ] ] ] ] ] 7 => array:3 [ "identificador" => "bb0040" "etiqueta" => "8." "referencia" => array:1 [ 0 => array:2 [ "contribucion" => array:1 [ 0 => array:2 [ "titulo" => "Clinical spectrum of cryptogenic organaising pneumonia" "autores" => array:1 [ 0 => array:2 [ "etal" => false "autores" => array:4 [ 0 => "R. Bellomo" 1 => "M. Finlay" 2 => "P. McLaughlin" 3 => "E. Tai" ] ] ] ] ] "host" => array:1 [ 0 => array:1 [ "Revista" => array:6 [ "tituloSerie" => "Thorax" "fecha" => "1995" "volumen" => "46" "paginaInicial" => "554" "paginaFinal" => "558" "link" => array:1 [ 0 => array:2 [ "url" => "https://www.ncbi.nlm.nih.gov/pubmed/1926023" "web" => "Medline" ] ] ] ] ] ] ] ] ] ] ] ] ] ] "idiomaDefecto" => "pt" "url" => "/08732159/0000001600000003/v1_201509151447/S0873215915300362/v1_201509151447/pt/main.assets" "Apartado" => array:4 [ "identificador" => "9575" "tipo" => "SECCION" "pt" => array:2 [ "titulo" => "Artigos originais" "idiomaDefecto" => true ] "idiomaDefecto" => "pt" ] "PDF" => "https://static.elsevier.es/multimedia/08732159/0000001600000003/v1_201509151447/S0873215915300362/v1_201509151447/pt/main.pdf?idApp=UINPBA00004E&text.app=https://journalpulmonology.org/" "EPUB" => "https://multimedia.elsevier.es/PublicationsMultimediaV1/item/epub/S0873215915300362?idApp=UINPBA00004E" ]
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ISSN: 08732159Original language: Portuguese
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| 2022 October | 29 | 35 | 64 |
| 2022 September | 21 | 45 | 66 |
| 2022 August | 41 | 48 | 89 |
| 2022 July | 27 | 44 | 71 |
| 2022 June | 20 | 33 | 53 |
| 2022 May | 31 | 46 | 77 |
| 2022 April | 23 | 35 | 58 |
| 2022 March | 18 | 41 | 59 |
| 2022 February | 27 | 43 | 70 |
| 2022 January | 25 | 45 | 70 |
| 2021 December | 18 | 40 | 58 |
| 2021 November | 23 | 41 | 64 |
| 2021 October | 24 | 34 | 58 |
| 2021 September | 35 | 52 | 87 |
| 2021 August | 25 | 30 | 55 |
| 2021 July | 19 | 26 | 45 |
| 2021 June | 24 | 34 | 58 |
| 2021 May | 25 | 44 | 69 |
| 2021 April | 29 | 65 | 94 |
| 2021 March | 52 | 33 | 85 |
| 2021 February | 36 | 23 | 59 |
| 2021 January | 19 | 19 | 38 |
| 2020 December | 50 | 10 | 60 |
| 2020 November | 34 | 19 | 53 |
| 2020 October | 32 | 16 | 48 |
| 2020 September | 52 | 22 | 74 |
| 2020 August | 57 | 24 | 81 |
| 2020 July | 88 | 22 | 110 |
| 2020 June | 39 | 20 | 59 |
| 2020 May | 53 | 18 | 71 |
| 2020 April | 72 | 26 | 98 |
| 2020 March | 50 | 13 | 63 |
| 2020 February | 38 | 30 | 68 |
| 2020 January | 46 | 9 | 55 |
| 2019 December | 42 | 21 | 63 |
| 2019 November | 48 | 12 | 60 |
| 2019 October | 39 | 19 | 58 |
| 2019 September | 41 | 19 | 60 |
| 2019 August | 74 | 20 | 94 |
| 2019 July | 56 | 19 | 75 |
| 2019 June | 54 | 8 | 62 |
| 2019 May | 59 | 20 | 79 |
| 2019 April | 51 | 30 | 81 |
| 2019 March | 104 | 11 | 115 |
| 2019 February | 80 | 12 | 92 |
| 2019 January | 81 | 24 | 105 |
| 2018 December | 38 | 13 | 51 |
| 2018 November | 6 | 0 | 6 |
| 2018 October | 22 | 8 | 30 |
| 2018 September | 37 | 13 | 50 |
| 2018 August | 82 | 23 | 105 |
| 2018 July | 70 | 25 | 95 |
| 2018 June | 80 | 20 | 100 |
| 2018 May | 108 | 25 | 133 |
| 2018 April | 83 | 28 | 111 |
| 2018 March | 98 | 32 | 130 |
| 2018 February | 38 | 8 | 46 |
| 2018 January | 67 | 14 | 81 |
| 2017 December | 64 | 23 | 87 |
| 2017 November | 55 | 33 | 88 |
| 2017 October | 43 | 13 | 56 |
| 2017 September | 28 | 11 | 39 |
| 2017 August | 29 | 8 | 37 |
| 2017 July | 49 | 10 | 59 |
| 2017 June | 40 | 13 | 53 |
| 2017 May | 61 | 9 | 70 |
| 2017 April | 28 | 19 | 47 |
| 2017 March | 45 | 14 | 59 |
| 2017 February | 39 | 4 | 43 |
| 2017 January | 19 | 5 | 24 |
| 2016 December | 55 | 5 | 60 |
| 2016 November | 90 | 9 | 99 |
| 2016 October | 30 | 19 | 49 |
| 2016 September | 8 | 4 | 12 |
| 2016 August | 4 | 2 | 6 |
| 2016 July | 4 | 6 | 10 |
| 2016 June | 5 | 0 | 5 |
| 2016 May | 0 | 12 | 12 |
| 2016 April | 4 | 1 | 5 |
| 2016 March | 8 | 6 | 14 |
| 2016 February | 7 | 10 | 17 |
| 2016 January | 5 | 5 | 10 |
| 2015 December | 10 | 2 | 12 |
| 2015 November | 3 | 5 | 8 |
| 2015 October | 3 | 4 | 7 |
Show all
