Caso Clínico\Clinical Case
Fibrose pulmonar secundária à amiodarona – A propósito de um caso clínico
Amiodarone induced pulmonary fibrosis – A clinical case report
1 Interna Complementar de Medicina Interna, Hospital de São João de Deus EPE, Serviço de Pneumologia (Director: Dr Francisco Costa), Serviço de Medicina (Directora: Drª Helena Rodrigues), Apartado 31 – EC4761-917 V. N. Famalicão
2 Assistente Hospitalar de Pneumologia, Hospital de São João de Deus EPE, Serviço de Pneumologia (Director: Dr Francisco Costa), Serviço de Medicina (Directora: Drª Helena Rodrigues), Apartado 31 – EC4761-917 V. N. Famalicão
3 Director do Serviço de Pneumologia, Hospital de São João de Deus EPE, Serviço de Pneumologia (Director: Dr Francisco Costa), Serviço de Medicina (Directora: Drª Helena Rodrigues), Apartado 31 – EC4761-917 V. N. Famalicão
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"apellidos" => "Silva" "referencia" => array:2 [ 0 => array:2 [ "etiqueta" => "<span class="elsevierStyleSup">1</span>" "identificador" => "af0005" ] 1 => array:2 [ "etiqueta" => "*" "identificador" => "cr0005" ] ] ] 1 => array:3 [ "nombre" => "Patrícia" "apellidos" => "Bacellar" "referencia" => array:1 [ 0 => array:2 [ "etiqueta" => "<span class="elsevierStyleSup">1</span>" "identificador" => "af0005" ] ] ] 2 => array:3 [ "nombre" => "Helena" "apellidos" => "Martins" "referencia" => array:1 [ 0 => array:2 [ "etiqueta" => "<span class="elsevierStyleSup">1</span>" "identificador" => "af0005" ] ] ] 3 => array:3 [ "nombre" => "Nélia" "apellidos" => "Tinoco" "referencia" => array:1 [ 0 => array:2 [ "etiqueta" => "<span class="elsevierStyleSup">2</span>" "identificador" => "af0010" ] ] ] 4 => array:3 [ "nombre" => "Francisco" "apellidos" => "Costa" "referencia" => array:1 [ 0 => array:2 [ "etiqueta" => "<span class="elsevierStyleSup">3</span>" "identificador" => "af0015" ] ] ] ] "afiliaciones" => array:3 [ 0 => array:3 [ "entidad" => "Interna Complementar de Medicina Interna, Hospital de São João de Deus EPE, Serviço de Pneumologia (Director: Dr Francisco Costa), Serviço de Medicina (Directora: Drª Helena Rodrigues), Apartado 31 – EC4761-917 V. N. Famalicão" "etiqueta" => "1" "identificador" => "af0005" ] 1 => array:3 [ "entidad" => "Assistente Hospitalar de Pneumologia, Hospital de São João de Deus EPE, Serviço de Pneumologia (Director: Dr Francisco Costa), Serviço de Medicina (Directora: Drª Helena Rodrigues), Apartado 31 – EC4761-917 V. N. Famalicão" "etiqueta" => "2" "identificador" => "af0010" ] 2 => array:3 [ "entidad" => "Director do Serviço de Pneumologia, Hospital de São João de Deus EPE, Serviço de Pneumologia (Director: Dr Francisco Costa), Serviço de Medicina (Directora: Drª Helena Rodrigues), Apartado 31 – EC4761-917 V. N. Famalicão" "etiqueta" => "3" "identificador" => "af0015" ] ] "correspondencia" => array:1 [ 0 => array:3 [ "identificador" => "cr0005" "etiqueta" => "*" "correspondencia" => "<span class="elsevierStyleBold">Contacto:</span> Marta Helena de Oliveira Novais da Silva Rua Gross Umstadt, 320 Quinta do Geão 4780-373 Santo Tirso" ] ] ] ] "titulosAlternativos" => array:1 [ "en" => array:1 [ "titulo" => "Amiodarone induced pulmonary fibrosis – A clinical case report" ] ] "pdfFichero" => "main.pdf" "tienePdf" => true "fechaRecibido" => "2006-06-02" "fechaAceptado" => "2006-07-28" "PalabrasClave" => array:2 [ "pt" => array:1 [ 0 => array:4 [ "clase" => "keyword" "titulo" => "Palavras-chave" "identificador" => "xpalclavsec568008" "palabras" => array:2 [ 0 => "Fibrose pulmonar" 1 => "toxicidade da amiodarona" ] ] ] "en" => array:1 [ 0 => array:4 [ "clase" => "keyword" "titulo" => "Key-words" "identificador" => "xpalclavsec568009" "palabras" => array:2 [ 0 => "Pulmonary fibrosis" 1 => "amiodarone toxicity" ] ] ] ] "tieneResumen" => true "resumen" => array:2 [ "pt" => array:2 [ "titulo" => "Resumo" "resumen" => "<span id="as0005" class="elsevierStyleSection elsevierViewall"><p id="sp0005" class="elsevierStyleSimplePara elsevierViewall">A amiodarona é um eficaz fármaco anti-arrítmico usado para tratar arritmias ventriculares e supra-ventriculares, mas não isento de reacções adversas. A toxicidade pulmonar é uma delas, relativamente rara (5 a 10% dos casos), e pode ser fatal. Há vários factores que aumentam a susceptibilidadade para esta toxicidade, tais como a idade avançada e a doença pulmonar preexistente.</p><p id="sp0010" class="elsevierStyleSimplePara elsevierViewall">Apresentamos um caso clínico de toxicidade pulmonar induzida pela amiodarona (fibrose pulmonar) num doente do sexo masculino, de 81 anos. Estava medicado com este fármaco, desde há 5 anos, com uma dose diária de 200 mg.</p><p id="sp0015" class="elsevierStyleSimplePara elsevierViewall">Após a suspensão do fármaco e tratamento com corticosteróides sistémicos, houve melhoria clínica, funcional e radiológica.</p><p id="sp0020" class="elsevierStyleSimplePara elsevierViewall">Este caso clínico realça a necessidade de uma monitorização e diagnóstico precoce dos efeitos adversos do tratamento com a amiodarona e a dificuldade no seu diagnóstico, devido à inespecificidade dos sintomas, das manifestações clínicas e dos resultados dos exames complementares de diagnóstico.</p><p id="sp0025" class="elsevierStyleSimplePara elsevierViewall"><span class="elsevierStyleBold">Rev Port Pneumol 2006; XII (6): 725-730</span></p></span>" ] "en" => array:2 [ "titulo" => "Abstract" "resumen" => "<span id="as0010" class="elsevierStyleSection elsevierViewall"><p id="sp0030" class="elsevierStyleSimplePara elsevierViewall">Amiodarone is an antiarrhytmic drug and it is used to treat supraventricular or ventricular rhythm disturbances. Nevertheless it is not free of side effects. Amiodarone-induced pulmonary toxicity is one of them and is relatively rare (5 to 10% of cases) and can be fatal. There are several cumulative factors that may enhance susceptibility to pulmonary toxicity, such as advanced age and pre-existing pulmonary dysfunction.</p><p id="sp0035" class="elsevierStyleSimplePara elsevierViewall">We present a case study of amiodarone-induced toxicity (pulmonary fibrosis) in an 81-year-old man. The patient had been treated with amiodarone for five years in daily dose 200 mg/day.</p><p id="sp0040" class="elsevierStyleSimplePara elsevierViewall">After withdrawing the drug and systemic corticoste-roid therapy, clinical, functional and radiological improvement was observed.</p><p id="sp0045" class="elsevierStyleSimplePara elsevierViewall">This case confirms the needs of a vigilant monitoring and early diagnosis of the adverse effects of amiodarone therapy, and the difficulty of diagnosing it due to the nonspecificity of symptoms, clinical findings, and test results.</p><p id="sp0050" class="elsevierStyleSimplePara elsevierViewall"><span class="elsevierStyleBold">Rev Port Pneumol 2006; XII (6): 725-730</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:9 [ 0 => array:3 [ "identificador" => "bb0005" "etiqueta" => "1." 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"referencia" => array:1 [ 0 => array:2 [ "contribucion" => array:1 [ 0 => array:1 [ "autores" => array:1 [ 0 => array:2 [ "etal" => false "autores" => array:1 [ 0 => "Interstitial Lung Disease" ] ] ] ] ] "host" => array:1 [ 0 => array:1 [ "LibroEditado" => array:5 [ "titulo" => "Interstitial lung disease related to specific drugs – Amiodarone pneumonitis or Amiodarone lung Schwartz, King" "paginaInicial" => "511" "paginaFinal" => "515" "edicion" => "4th edition" "serieFecha" => "2003" ] ] ] ] ] ] 3 => array:3 [ "identificador" => "bb0020" "etiqueta" => "4." "referencia" => array:1 [ 0 => array:1 [ "referenciaCompleta" => "Lee Goldman, Dennis Ansiello. Interstitial Lung Disease. Cecil Textbook of Medicine, 22<span class="elsevierStyleSup">nd</span> edition: 523-531." ] ] ] 4 => array:3 [ "identificador" => "bb0025" "etiqueta" => "5." 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"referencia" => array:1 [ 0 => array:2 [ "contribucion" => array:1 [ 0 => array:2 [ "titulo" => "Pulmonary toxicity in patients receiving low-dose amiodarone" "autores" => array:1 [ 0 => array:2 [ "etal" => false "autores" => array:5 [ 0 => "Michael Ott" 1 => "Andreas Khoor" 2 => "Jack Leventhal" 3 => "Timothy Patrick" 4 => "Charles Burger" ] ] ] ] ] "host" => array:1 [ 0 => array:1 [ "Revista" => array:6 [ "tituloSerie" => "Chest" "fecha" => "2003" "volumen" => "123" "paginaInicial" => "646" "paginaFinal" => "651" "link" => array:1 [ 0 => array:2 [ "url" => "https://www.ncbi.nlm.nih.gov/pubmed/12576397" "web" => "Medline" ] ] ] ] ] ] ] ] 6 => array:3 [ "identificador" => "bb0035" "etiqueta" => "7." "referencia" => array:1 [ 0 => array:2 [ "contribucion" => array:1 [ 0 => array:2 [ "titulo" => "Gink. Amiodarone induced pulmonary toxicity" "autores" => array:1 [ 0 => array:2 [ "etal" => false "autores" => array:2 [ 0 => "Z. Kanji" 1 => "R. Sunderji" ] ] ] ] ] "host" => array:1 [ 0 => array:1 [ "Revista" => array:7 [ "tituloSerie" => "Pharmacotherapy" "fecha" => "1999" "volumen" => "19" "numero" => "12" "paginaInicial" => "1463" "paginaFinal" => "1466" "link" => array:1 [ 0 => array:2 [ "url" => "https://www.ncbi.nlm.nih.gov/pubmed/10600099" "web" => "Medline" ] ] ] ] ] ] ] ] 7 => array:3 [ "identificador" => "bb0040" "etiqueta" => "8." "referencia" => array:1 [ 0 => array:2 [ "contribucion" => array:1 [ 0 => array:1 [ "autores" => array:1 [ 0 => array:2 [ "etal" => false "autores" => array:5 [ 0 => "Alonso-Fernandez" 1 => "Alvarez Sala" 2 => "O. Mediano" 3 => "I. Torres" 4 => "I. Moreno" ] ] ] ] ] "host" => array:1 [ 0 => array:1 [ "Revista" => array:7 [ "tituloSerie" => "An Med Interna" "fecha" => "2003" "volumen" => "20" "numero" => "8" "paginaInicial" => "419" "paginaFinal" => "420" "link" => array:1 [ 0 => array:2 [ "url" => "https://www.ncbi.nlm.nih.gov/pubmed/14516264" "web" => "Medline" ] ] ] ] ] ] ] ] 8 => array:3 [ "identificador" => "bb0045" "etiqueta" => "9." "referencia" => array:1 [ 0 => array:2 [ "contribucion" => array:1 [ 0 => array:2 [ "titulo" => "Diagnosis of amiodarone pulmonary toxicity whith high-resolution computerized tomographic scan" "autores" => array:1 [ 0 => array:2 [ "etal" => false "autores" => array:4 [ 0 => "R.M. Siniakowicz" 1 => "D. Narula" 2 => "B. Suster" 3 => "J.S. Steinberg" ] ] ] ] ] "host" => array:1 [ 0 => array:1 [ "Revista" => array:7 [ "tituloSerie" => "J Cardiovasc Electrophysiol" "fecha" => "2001" "volumen" => "12" "numero" => "4" "paginaInicial" => "431" "paginaFinal" => "436" "link" => array:1 [ 0 => array:2 [ "url" => "https://www.ncbi.nlm.nih.gov/pubmed/11332563" "web" => "Medline" ] ] ] ] ] ] ] ] ] ] ] ] ] ] "idiomaDefecto" => "pt" "url" => "/08732159/0000001200000006/v1_201509071353/S0873215915304608/v1_201509071353/pt/main.assets" "Apartado" => array:4 [ "identificador" => "43381" "tipo" => "SECCION" "pt" => array:2 [ "titulo" => "Casos Clínicos/Clinical Cases" "idiomaDefecto" => true ] "idiomaDefecto" => "pt" ] "PDF" => "https://static.elsevier.es/multimedia/08732159/0000001200000006/v1_201509071353/S0873215915304608/v1_201509071353/pt/main.pdf?idApp=UINPBA00004E&text.app=https://journalpulmonology.org/" "EPUB" => "https://multimedia.elsevier.es/PublicationsMultimediaV1/item/epub/S0873215915304608?idApp=UINPBA00004E" ]
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ISSN: 08732159Original language: Portuguese
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