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                      "titulo" => "Cryptogenic fibrosing alveolitis&#58; a study of an indigenous African population"
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                            2 => "H&#46; Levy"
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                  "host" => array:1 [
                    0 => array:1 [
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                        "tituloSerie" => "Respiration &#40;Herrlisheim&#41;"
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                        "volumen" => "57"
                        "paginaInicial" => "364"
                        "paginaFinal" => "371"
                      ]
                    ]
                  ]
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                  "contribucion" => array:1 [
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                      "titulo" => "Idiopathic pulmonary fibrosis&#46; Clinical relevance of pathologic classification"
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                        0 => array:2 [
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                          "autores" => array:2 [
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                        "tituloSerie" => "Am J Respir Crit Care Med"
                        "fecha" => "1998"
                        "volumen" => "157"
                        "paginaInicial" => "1301"
                        "paginaFinal" => "1315"
                        "link" => array:1 [
                          0 => array:2 [
                            "url" => "https://www.ncbi.nlm.nih.gov/pubmed/9563754"
                            "web" => "Medline"
                          ]
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                      "titulo" => "Idiopathic pulmonary fibrosis&#58; diagnosis and treatment&#46; International Consensus Statement"
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                          "colaboracion" => "American Thoracic Society &#47; European Respiratory Society"
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                        "tituloSerie" => "Am J Respir Crit Care Med"
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                        "paginaInicial" => "646"
                        "paginaFinal" => "664"
                        "link" => array:1 [
                          0 => array:2 [
                            "url" => "https://www.ncbi.nlm.nih.gov/pubmed/10673212"
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                        "paginaInicial" => "396"
                        "paginaFinal" => "404"
                        "link" => array:1 [
                          0 => array:2 [
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                            2 => "Y&#46; Kawabata"
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                        "tituloSerie" => "Chest"
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                        "paginaFinal" => "1812"
                        "link" => array:1 [
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                            "url" => "https://www.ncbi.nlm.nih.gov/pubmed/8404104"
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                            2 => "M&#46; Sakatani"
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                      "Revista" => array:5 [
                        "tituloSerie" => "Am J Roentgenol"
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                        "paginaFinal" => "83"
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                        "paginaFinal" => "967"
                        "link" => array:1 [
                          0 => array:2 [
                            "url" => "https://www.ncbi.nlm.nih.gov/pubmed/15968010"
                            "web" => "Medline"
                          ]
                        ]
                      ]
                    ]
                  ]
                ]
              ]
            ]
            9 => array:3 [
              "identificador" => "bib10"
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                0 => array:2 [
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                    0 => array:2 [
                      "titulo" => "Double-blind placebo-controlled trial of pirfenidone in patients with idiopathic pulmonary fibrosis"
                      "autores" => array:1 [
                        0 => array:2 [
                          "etal" => true
                          "autores" => array:3 [
                            0 => "A&#46; Azuma"
                            1 => "T&#46; Nukwa"
                            2 => "E&#46; Tsuboi"
                          ]
                        ]
                      ]
                    ]
                  ]
                  "host" => array:1 [
                    0 => array:2 [
                      "doi" => "10.1164/rccm.200404-571OC"
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                        "tituloSerie" => "Am J Respir Crit Care Med"
                        "fecha" => "2005"
                        "volumen" => "171"
                        "paginaInicial" => "1040"
                        "paginaFinal" => "1047"
                        "link" => array:1 [
                          0 => array:2 [
                            "url" => "https://www.ncbi.nlm.nih.gov/pubmed/15665326"
                            "web" => "Medline"
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                ]
              ]
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                    0 => array:2 [
                      "titulo" => "Acute exacerbation of idiopathic pulmonary fibrosis&#58; frequency and clinical features"
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                        0 => array:2 [
                          "etal" => true
                          "autores" => array:3 [
                            0 => "D&#46;S&#46; Kim"
                            1 => "J&#46;H&#46; Park"
                            2 => "B&#46;K&#46; Park"
                          ]
                        ]
                      ]
                    ]
                  ]
                  "host" => array:1 [
                    0 => array:1 [
                      "Revista" => array:5 [
                        "tituloSerie" => "Eur Resp J"
                        "fecha" => "2006"
                        "volumen" => "27"
                        "paginaInicial" => "143"
                        "paginaFinal" => "150"
                      ]
                    ]
                  ]
                ]
              ]
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            11 => array:3 [
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                0 => array:2 [
                  "contribucion" => array:1 [
                    0 => array:2 [
                      "titulo" => "Bronchoalveolar lavage as a possible cause of acute exacerbation in idiopathic pulmonary fibrosis patients"
                      "autores" => array:1 [
                        0 => array:2 [
                          "etal" => true
                          "autores" => array:3 [
                            0 => "N&#46; Hiwatari"
                            1 => "S&#46; Shimura"
                            2 => "T&#46; Takishima"
                          ]
                        ]
                      ]
                    ]
                  ]
                  "host" => array:1 [
                    0 => array:1 [
                      "Revista" => array:6 [
                        "tituloSerie" => "Tohoku J Exp Med"
                        "fecha" => "1994"
                        "volumen" => "174"
                        "paginaInicial" => "379"
                        "paginaFinal" => "386"
                        "link" => array:1 [
                          0 => array:2 [
                            "url" => "https://www.ncbi.nlm.nih.gov/pubmed/7732520"
                            "web" => "Medline"
                          ]
                        ]
                      ]
                    ]
                  ]
                ]
              ]
            ]
            12 => array:3 [
              "identificador" => "bib13"
              "etiqueta" => "13&#46;"
              "referencia" => array:1 [
                0 => array:2 [
                  "contribucion" => array:1 [
                    0 => array:2 [
                      "titulo" => "Acute exacerbation of idiopathic pulmonary fibrosis following surgical lung biopsy"
                      "autores" => array:1 [
                        0 => array:2 [
                          "etal" => true
                          "autores" => array:3 [
                            0 => "Y&#46; Kondoh"
                            1 => "H&#46; Taniguchi"
                            2 => "M&#46; Kitaichi"
                          ]
                        ]
                      ]
                    ]
                  ]
                  "host" => array:1 [
                    0 => array:2 [
                      "doi" => "10.1016/j.rmed.2006.02.002"
                      "Revista" => array:6 [
                        "tituloSerie" => "Respir Med"
                        "fecha" => "2006"
                        "volumen" => "100"
                        "paginaInicial" => "1753"
                        "paginaFinal" => "1759"
                        "link" => array:1 [
                          0 => array:2 [
                            "url" => "https://www.ncbi.nlm.nih.gov/pubmed/16584880"
                            "web" => "Medline"
                          ]
                        ]
                      ]
                    ]
                  ]
                ]
              ]
            ]
            13 => array:3 [
              "identificador" => "bib14"
              "etiqueta" => "14&#46;"
              "referencia" => array:1 [
                0 => array:2 [
                  "contribucion" => array:1 [
                    0 => array:2 [
                      "titulo" => "Acute exacerbation of interstitial fibrosis after pulmonary resection"
                      "autores" => array:1 [
                        0 => array:2 [
                          "etal" => true
                          "autores" => array:3 [
                            0 => "M&#46; Y&#252;ksel"
                            1 => "M&#46;O&#46; &#214;zyurtkan"
                            2 => "K&#46; Bostanci"
                          ]
                        ]
                      ]
                    ]
                  ]
                  "host" => array:1 [
                    0 => array:2 [
                      "doi" => "10.1016/j.athoracsur.2005.09.036"
                      "Revista" => array:6 [
                        "tituloSerie" => "Ann Thorac Surg"
                        "fecha" => "2006"
                        "volumen" => "82"
                        "paginaInicial" => "336"
                        "paginaFinal" => "338"
                        "link" => array:1 [
                          0 => array:2 [
                            "url" => "https://www.ncbi.nlm.nih.gov/pubmed/16798250"
                            "web" => "Medline"
                          ]
                        ]
                      ]
                    ]
                  ]
                ]
              ]
            ]
            14 => array:3 [
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                  "contribucion" => array:1 [
                    0 => array:2 [
                      "titulo" => "Histopathologic features and outcome of patients with acute exacerbation of idiopathic pulmonary fibrosis undergoing surgical lung biopsy"
                      "autores" => array:1 [
                        0 => array:2 [
                          "etal" => false
                          "autores" => array:3 [
                            0 => "J&#46;G&#46; Parambil"
                            1 => "J&#46;L&#46; Myers"
                            2 => "J&#46;H&#46; Ryu"
                          ]
                        ]
                      ]
                    ]
                  ]
                  "host" => array:1 [
                    0 => array:2 [
                      "doi" => "10.1378/chest.128.5.3310"
                      "Revista" => array:6 [
                        "tituloSerie" => "Chest"
                        "fecha" => "2005"
                        "volumen" => "128"
                        "paginaInicial" => "3310"
                        "paginaFinal" => "3315"
                        "link" => array:1 [
                          0 => array:2 [
                            "url" => "https://www.ncbi.nlm.nih.gov/pubmed/16304277"
                            "web" => "Medline"
                          ]
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                      ]
                    ]
                  ]
                ]
              ]
            ]
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                    0 => array:2 [
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                          "autores" => array:4 [
                            0 => "R&#46; Dallari"
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                            2 => "M&#46; Paci"
                            3 => "A&#46; Cavazza"
                          ]
                        ]
                      ]
                    ]
                  ]
                  "host" => array:1 [
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                      "Revista" => array:5 [
                        "tituloSerie" => "Eur Respir J"
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                        "volumen" => "23"
                        "paginaInicial" => "792"
                        "link" => array:1 [
                          0 => array:2 [
                            "url" => "https://www.ncbi.nlm.nih.gov/pubmed/15176701"
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Vol. 15. Issue 2.
Pages 305-312 (March - April 2009)
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Vol. 15. Issue 2.
Pages 305-312 (March - April 2009)
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Exacerbação aguda da fibrose pulmonar idiopática
Acute exacerbation of idiopathic pulmonary fibrosis
Visits
1941
Natália Melo1,
Corresponding author
nataliafmelo@hotmail.com

Serviço de Pneumologia, Hospital de S. João, Alameda Professor Hernâni Monteiro, 4202-451 Porto. Telefone: 919371855.
, Carla Damas2, Conceição Souto Moura3, António Morais2, Venceslau Hespanhol4, Fátima Carneiro5
1 Interna Complementar de Pneumologia
2 Assistente Hospitalar de Pneumologia
3 Assistente Hospitalar Graduada de Anatomia Patológica
4 Serviço de Pneumologia do Hospital S. João
5 Serviço de Anatomia Patológica do Hospital S. João
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Resumo

Alguns doentes com fibrose pulmonar idiopática (FPI) apresentam durante a sua evolução fases de agravamento clínico sem causa conhecida, designadas como “exacerbação aguda” ou “fase acelerada” da doença (EA). Caracterizam-se pelo agravamento marcado da dispneia, hipoxemia e pelo aparecimento de novas opacidades pulmonares ou pelo agravamento das já existentes no estudo imagiológico. Os achados histológicos típicos são o dano alveolar difuso (DAD) sobreposto a alterações de pneumonia intersticial usual (UIP). Esta entidade clínica associa-se a uma mortalidade elevada, não havendo até ao momento nenhuma terapêutica de comprovada eficácia.

Os autores descrevem os casos clínicos de cinco doentes que apresentaram alterações clínicas, funcionais e radiológicas sugestivas de EA-FPI, assim como o tratamento efectuado e a evolução observada, enquadrando-os na discussão das características normalmente apresentadas por esta entidade.

Palavras-chave:
Fibrose pulmonar idiopática
exacerbação aguda
Abstract

Some patients with Idiopathic Pulmonary Fibrosis (IPF) have disease accelerated deterioration without identifiable cause referred as “acute exacerbation” or “accelerated stage”. It is characterized by severe worsening of dyspnea, hypoxemia and new or progressive opacities on imaging studies. The typical histological findings are diffuse alveolar damage in addition to the features of usual interstitial pneumonia pattern. Mortality in this clinical entity is very high and no efficacious therapeutic have been described.

The authors describe the clinical, functional and radiological features, treatment and evolution of five patients with IPF acute exacerbation. A discussion will be carry out concerning the IPF acute exacerbation usual features comparing with the alterations noticed in those patients.

Key words:
Idiopathic pulmonary fibrosis
acute exacerbation
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Bibliografia
[1.]
D.S. Kim, H.R. Collard, T.E. King Jr..
Classification and natural history of idiopathic interstitial pneumonias.
The proceedings of the American Thoracic Society, 3 (2006), pp. 285-292
[2.]
C. Smith, C. Feldman, H. Levy, et al.
Cryptogenic fibrosing alveolitis: a study of an indigenous African population.
Respiration (Herrlisheim), 57 (1990), pp. 364-371
[3.]
A.L. Katzenstein, J.L. Myers.
Idiopathic pulmonary fibrosis. Clinical relevance of pathologic classification.
Am J Respir Crit Care Med, 157 (1998), pp. 1301-1315
[4.]
American Thoracic Society / European Respiratory Society.
Idiopathic pulmonary fibrosis: diagnosis and treatment. International Consensus Statement.
Am J Respir Crit Care Med, 161 (2000), pp. 646-664
[5.]
R.J. Panos, R. Mortenson, S.A. Niccoli, et al.
Clinical deterioration in patients with idiopathic pulmonary fibrosis: causes and assessment.
Am J Med, 88 (1990), pp. 396-404
[6.]
Y. Kondoh, H. Taniguchi, Y. Kawabata, et al.
Acute exacerbation in idiopathic pulmonary fibrosis: analysis of clinical and pathologic findings in three cases.
Chest, 103 (1993), pp. 1808-1812
[7.]
M. Akira, H. Hamada, M. Sakatani, et al.
CT findings during phase of accelerated deterioration in patients with idiopathic pulmonary fibrosis.
Am J Roentgenol, 168 (1997), pp. 79-83
[8.]
V. Ambrosini, A. Cancellieri, M. Chilosi, et al.
Acute exacerbation of idiopathic pulmonary fibrosis: report of a series.
Eur Respir J, 22 (2003), pp. 821-826
[9.]
F.J. Martinez, S. Safrin, D. Weycker, et al.
The clinical course of patients with idiopathic pulmonary fibrosis.
Ann Intern Med, 142 (2005), pp. 963-967
[10.]
A. Azuma, T. Nukwa, E. Tsuboi, et al.
Double-blind placebo-controlled trial of pirfenidone in patients with idiopathic pulmonary fibrosis.
Am J Respir Crit Care Med, 171 (2005), pp. 1040-1047
[11.]
D.S. Kim, J.H. Park, B.K. Park, et al.
Acute exacerbation of idiopathic pulmonary fibrosis: frequency and clinical features.
Eur Resp J, 27 (2006), pp. 143-150
[12.]
N. Hiwatari, S. Shimura, T. Takishima, et al.
Bronchoalveolar lavage as a possible cause of acute exacerbation in idiopathic pulmonary fibrosis patients.
Tohoku J Exp Med, 174 (1994), pp. 379-386
[13.]
Y. Kondoh, H. Taniguchi, M. Kitaichi, et al.
Acute exacerbation of idiopathic pulmonary fibrosis following surgical lung biopsy.
Respir Med, 100 (2006), pp. 1753-1759
[14.]
M. Yüksel, M.O. Özyurtkan, K. Bostanci, et al.
Acute exacerbation of interstitial fibrosis after pulmonary resection.
Ann Thorac Surg, 82 (2006), pp. 336-338
[15.]
J.G. Parambil, J.L. Myers, J.H. Ryu.
Histopathologic features and outcome of patients with acute exacerbation of idiopathic pulmonary fibrosis undergoing surgical lung biopsy.
Chest, 128 (2005), pp. 3310-3315
[16.]
R. Dallari, M. Foglia, M. Paci, A. Cavazza.
Acute exacerbation of idiopathic pulmonary fibrosis.
Eur Respir J, 23 (2004), pp. 792
Copyright © 2009. Sociedade Portuguesa de Pneumologia
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