Caso Clínico/Case Report
A asma e os seus diagnósticos diferenciais
Asthma and its differential diagnoses
Alexandra Bento1,
, Ana Maria Arrobas2
Corresponding author
alexitbento@gmail.com
Centro Hospitalar de Coimbra EPE, Serviço de Pneumologia, São Martinho do Bispo, 3000 Coimbra.
Centro Hospitalar de Coimbra EPE, Serviço de Pneumologia, São Martinho do Bispo, 3000 Coimbra.
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"referencia" => array:1 [ 0 => array:2 [ "etiqueta" => "<span class="elsevierStyleSup">2</span>" "identificador" => "af0010" ] ] ] ] "afiliaciones" => array:2 [ 0 => array:3 [ "entidad" => "Interna do Internato Complementar de Pneumologia da Unidade de Saúde Local EPE Guarda" "etiqueta" => "1" "identificador" => "af0005" ] 1 => array:3 [ "entidad" => "Assistente Hospitalar Graduada de Pneumologia do Centro Hospitalar de Coimbra, EPE" "etiqueta" => "2" "identificador" => "af0010" ] ] "correspondencia" => array:1 [ 0 => array:3 [ "identificador" => "cr0005" "etiqueta" => "*" "correspondencia" => "Centro Hospitalar de Coimbra EPE, Serviço de Pneumologia, São Martinho do Bispo, 3000 Coimbra." ] ] ] ] "titulosAlternativos" => array:1 [ "en" => array:1 [ "titulo" => "Asthma and its differential diagnoses" ] ] "pdfFichero" => "main.pdf" "tienePdf" => true "fechaRecibido" => "2009-04-13" "fechaAceptado" => "2009-05-14" "PalabrasClave" => array:2 [ "pt" => array:1 [ 0 => array:4 [ "clase" => "keyword" "titulo" => "Palavras-chave" "identificador" => "xpalclavsec570356" "palabras" => array:3 [ 0 => "Asma" 1 => "aspergilose broncopulmonar alérgica" 2 => "critérios de diagnóstico" ] ] ] "en" => array:1 [ 0 => array:4 [ "clase" => "keyword" "titulo" => "Key-words" "identificador" => "xpalclavsec570355" "palabras" => array:3 [ 0 => "Asthma" 1 => "allergic bronchopulmonary aspergillosis" 2 => "diagnostic guidelines" ] ] ] ] "tieneResumen" => true "resumen" => array:2 [ "pt" => array:2 [ "titulo" => "Resumo" "resumen" => "<span id="as0005" class="elsevierStyleSection elsevierViewall"><p id="sp0005" class="elsevierStyleSimplePara elsevierViewall">A aspergilose broncopulmonar alérgica (ABPA) ocorre em doentes não imunocomprometidos e é uma patologia de hipersensibilidade induzida pelo <span class="elsevierStyleItalic">Aspergillus</span><span class="elsevierStyleSup">5</span>.</p><p id="sp0010" class="elsevierStyleSimplePara elsevierViewall">Estima-se que esteja presente em cerca de 7-14% dos casos de asma crónica corticodependente e o no mesmo número de casos de fibrose quística. A maioria das ABPA são identificadas pela 30-50.ª décadas de vida, mas podem surgir na infância<span class="elsevierStyleSup">1</span>.</p><p id="sp0015" class="elsevierStyleSimplePara elsevierViewall">O diagnóstico baseia-se na presença de uma combinação de critérios clínicos, biológicos e radiológicos<span class="elsevierStyleSup">5</span>. A doença apresenta-se com largo espectro de gravidade, pode ser reconhecida precocemente e tratada agressivamente, impedindo a sua progressão para um estádio de doença grave e debilitante requerendo transplante pulmonar<span class="elsevierStyleSup">1</span>.</p><p id="sp0020" class="elsevierStyleSimplePara elsevierViewall">Os autores relatam o caso de uma doente de 41 anos, com antecedentes de asma alérgica desde a infância. Uma asma grave, de difícil controlo e com recurso a corticoterapia sistémica por longos períodos.</p><p id="sp0025" class="elsevierStyleSimplePara elsevierViewall"><span class="elsevierStyleBold">Rev Port Pneumol 2009; XV (6): 1185-1191</span></p></span>" ] "en" => array:2 [ "titulo" => "Abstract" "resumen" => "<span id="as0010" class="elsevierStyleSection elsevierViewall"><p id="sp0030" class="elsevierStyleSimplePara elsevierViewall">Allergic bronchopulmonary aspergillosis (ABPA) occurs in immunocompetent patients and belongs to the <span class="elsevierStyleItalic">Aspergillus</span><span class="elsevierStyleSup">5</span> induced hypersensitivity disorders.</p><p id="sp0035" class="elsevierStyleSimplePara elsevierViewall">It is estimated that ABPA complicates approximately 7-14% of cases of chronic steroid-dependent asthma and the same amount of cases of cystic fibrosis.</p><p id="sp0040" class="elsevierStyleSimplePara elsevierViewall">A diagnosis of ABPA is based on a combination of clinical, biological and radiology criteria4.</p><p id="sp0045" class="elsevierStyleSimplePara elsevierViewall">There is a broad spectrum of disease severity. Early detection and aggressively management will impede progressive lung damage to a severe and debilitating disease requiring lung transplantation.</p><p id="sp0050" class="elsevierStyleSimplePara elsevierViewall">The authors describe the case of a 41 year-old female with a history of allergic asthma from childhood. It was a severe, difficult to control asthma treated with systemic corticosteroids for long periods.</p><p id="sp0055" class="elsevierStyleSimplePara elsevierViewall"><span class="elsevierStyleBold">Rev Port Pneumol 2009; XV (6): 1185-1191</span></p></span>" ] ] "lecturaRecomendada" => array:1 [ 0 => array:3 [ "vista" => "all" "titulo" => "<span class="elsevierStyleSectionTitle" id="st0025">Bibliografia</span>" "seccion" => array:1 [ 0 => array:2 [ "vista" => "all" "bibliografiaReferencia" => array:10 [ 0 => array:3 [ "identificador" => "bb0005" "etiqueta" => "1." 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Jett" ] ] ] ] ] "host" => array:1 [ 0 => array:1 [ "LibroEditado" => array:3 [ "titulo" => "Hardcourt" "edicion" => "1.ª edição" "serieFecha" => "2001" ] ] ] ] ] ] 4 => array:3 [ "identificador" => "bb0025" "etiqueta" => "5." "referencia" => array:1 [ 0 => array:2 [ "contribucion" => array:1 [ 0 => array:2 [ "titulo" => "Allergic bronchopulmonary aspergillosis" "autores" => array:1 [ 0 => array:2 [ "etal" => true "autores" => array:1 [ 0 => "Tillie-Leblond" ] ] ] ] ] "host" => array:1 [ 0 => array:2 [ "doi" => "10.1111/j.1398-9995.2005.00887.x" "Revista" => array:7 [ "tituloSerie" => "Allergy" "fecha" => "2005" "volumen" => "60" "numero" => "8" "paginaInicial" => "1004" "paginaFinal" => "1013" "link" => array:1 [ 0 => array:2 [ "url" => "https://www.ncbi.nlm.nih.gov/pubmed/15969680" "web" => "Medline" ] ] ] ] ] ] ] ] 5 => array:3 [ "identificador" => "bb0030" "etiqueta" => "6." "referencia" => array:1 [ 0 => array:2 [ "contribucion" => array:1 [ 0 => array:1 [ "autores" => array:1 [ 0 => array:2 [ "etal" => true "autores" => array:1 [ 0 => "Cheezum" ] ] ] ] ] "host" => array:1 [ 0 => array:1 [ "Libro" => array:2 [ "titulo" => "Allergy & clinical immunology; allergic bronchopulmonary aspergillosis" "fecha" => "2008" ] ] ] ] ] ] 6 => array:3 [ "identificador" => "bb0035" "etiqueta" => "7." "referencia" => array:1 [ 0 => array:2 [ "contribucion" => array:1 [ 0 => array:2 [ "titulo" => "A randomized trial of itraconazole in allergic bronchopulmonary aspergillosis" "autores" => array:1 [ 0 => array:2 [ "etal" => true "autores" => array:1 [ 0 => "Stevens" ] ] ] ] ] "host" => array:1 [ 0 => array:2 [ "doi" => "10.1056/NEJM200003163421102" "Revista" => array:7 [ "tituloSerie" => "N Engl J Med" "fecha" => "2000" "volumen" => "342" "numero" => "11" "paginaInicial" => "756" "paginaFinal" => "762" "link" => array:1 [ 0 => array:2 [ "url" => "https://www.ncbi.nlm.nih.gov/pubmed/10717010" "web" => "Medline" ] ] ] ] ] ] ] ] 7 => array:3 [ "identificador" => "bb0040" "etiqueta" => "8." "referencia" => array:1 [ 0 => array:2 [ "contribucion" => array:1 [ 0 => array:2 [ "titulo" => "Allergic bronchopulmonary aspergillosis: challenges in diagnosis" "autores" => array:1 [ 0 => array:2 [ "etal" => true "autores" => array:1 [ 0 => "Viswanath" ] ] ] ] ] "host" => array:1 [ 0 => array:1 [ "Revista" => array:4 [ "tituloSerie" => "Medscape General Medicine" "fecha" => "1999" "volumen" => "1" "numero" => "3" ] ] ] ] ] ] 8 => array:3 [ "identificador" => "bb0045" "etiqueta" => "9." "referencia" => array:1 [ 0 => array:2 [ "contribucion" => array:1 [ 0 => array:2 [ "titulo" => "Allergic bronchopulmonary aspergillosis treated successfully with omalizumab: three case reports" "autores" => array:1 [ 0 => array:2 [ "etal" => true "autores" => array:1 [ 0 => "J. Collins" ] ] ] ] ] "host" => array:1 [ 0 => array:1 [ "Revista" => array:5 [ "tituloSerie" => "Ann Alllergy Asthma Immunol" "fecha" => "2008" "volumen" => "100" "numero" => "Suppl" "paginaInicial" => "A7" ] ] ] ] ] ] 9 => array:3 [ "identificador" => "bb0050" "etiqueta" => "10." "referencia" => array:1 [ 0 => array:2 [ "contribucion" => array:1 [ 0 => array:2 [ "titulo" => "Treatment of allergic bronchopulmonary aspergillosis (ABPA) in CF with anti-IgE antibody (omalizumab)" "autores" => array:1 [ 0 => array:2 [ "etal" => true "autores" => array:1 [ 0 => "Adaobi Kanu" ] ] ] ] ] "host" => array:1 [ 0 => array:2 [ "doi" => "10.1002/ppul.20907" "Revista" => array:7 [ "tituloSerie" => "Pediatric Pulmonology" "fecha" => "2008" "volumen" => "43" "numero" => "12" "paginaInicial" => "1249" "paginaFinal" => "1251" "link" => array:1 [ 0 => array:2 [ "url" => "https://www.ncbi.nlm.nih.gov/pubmed/19009619" "web" => "Medline" ] ] ] ] ] ] ] ] ] ] ] ] ] ] "idiomaDefecto" => "pt" "url" => "/08732159/0000001500000006/v1_201509151513/S0873215915302002/v1_201509151513/pt/main.assets" "Apartado" => array:4 [ "identificador" => "43360" "tipo" => "SECCION" "pt" => array:2 [ "titulo" => "Casos Clínicos/Cases Reports" "idiomaDefecto" => true ] "idiomaDefecto" => "pt" ] "PDF" => "https://static.elsevier.es/multimedia/08732159/0000001500000006/v1_201509151513/S0873215915302002/v1_201509151513/pt/main.pdf?idApp=UINPBA00004E&text.app=https://journalpulmonology.org/" "EPUB" => "https://multimedia.elsevier.es/PublicationsMultimediaV1/item/epub/S0873215915302002?idApp=UINPBA00004E" ]
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ISSN: 08732159Original language: Portuguese
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