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Vol. 14. Issue 1.
Pages 89-112 (January - February 2008)
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Vol. 14. Issue 1.
Pages 89-112 (January - February 2008)
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Fibrose quística: Revisão
Cystic fibrosis: Review
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1078
C. Damas1,
, A. Amorim2, I. Gomes3, V.P. Hespanhol4
1 Interna complementar de pneumologia
2 Assistente hospitalar de pneumologia
3 Assistente hospitalar graduada de pneumologia
4 Serviço de Pneumologia do Hospital de São João, Porto Alameda Hernâni Monteiro 4200 Porto
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Resumo

A fibrose quística (FQ) é a doença autossómica recessiva mais frequente na raça caucasiana. Caracteriza-se por mutações na CFTR, uma proteína transmembranar responsável pelo transporte de cloretos. Esta proteína tem uma ampla distribuição epitelial, o que dá um carácter sistémico a esta doença e consequentemente múltiplas manifestações clínicas de gravidade variável. A melhoria dos cuidados de saúde, associada ao desenvolvimento do arsenal terapêutico, permitiu um aumento da sobrevida destes doentes, de tal forma que a FQ já não pode ser abordada como doença da idade pediátrica. Também a evolução técnica na transplantação abriu novas perspectivas quanto ao tratamento desta afecção.

Assim, cada vez mais esta patologia implica um envolvimento multidisciplinar no qual a pneumologia tem uma parte preponderante.

Palavras-chave:
Fibrose quística
revisão
Abstract

Cystic Fibrosis (CF) is the recessive autossomic disease more frequent in the caucasian race. The main characteristic is a mutation in CFTR, a trans-membranar protein, responsible for chlorates transportation. This protein has a diffuse epithelial distribution, which gives a multissistemic involvement to this disease, with clinical manifestations with variable degrees of severity. The development of better health care associated with new therapeutic options became responsible for an increase of survival, so CF is no longer a paediatric disease. Lung transplantation also has an important role, bringing new treatment perspectives.

So, this pathology has an increased multi-disciplinary involvement in which the pulmonologist have a preponderant role.

Key-words:
Cystic fibrosis
review
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Bibliografia
[1.]
Schidlow D, Fiel S. Cystic Fibrosis in Clinical Respiratory Medicine; chapter 40, pp 499-513.
[2.]
D.H. Andersen.
Cystic fibrosis of the pancreas and its relation to celiac disease. A clinical and pathological study.
Am J Dis Child, 56 (1938), pp. 344-399
[3.]
D. Faber.
Pancreatic function and disease in early life.
Arch Path, 37 (1944), pp. 328
[4.]
M.D. Bethesda.
Cystic Fibrosis Foundation.
Patient Registry, (2000),
[5.]
R.M.G. Moreno, A.S. Posadas, A.C. Espinosa.
pp. 9-20
[6.]
R. Stein.
The diagnosis of Cystic Fibrosis.
New Eng J Med, 336 (1997), pp. 487-497
[7.]
Cystic Fibrosis Foundation. Patient Registry 2004 – Annual date report. Bethesda MD. Cystic Fibrosis Foundation, 2005.
[8.]
Cystic Fibrosis Foundation 2006. www.cff.org.
[9.]
J.R. Yankaskas, et al.
Cystic Fibrosis Adult Care Consensus Conference Report.
Chest, 125 (2004), pp. 15-39
[10.]
W.B. Guggino, S.P. Banks-Schlegl.
Macromolecular interactions and ion transport in Cystic Fibrosis.
Am J Resp Critical Care Med, 170 (2004), pp. 815
[11.]
The Cystic fibrosis genetic analysis consortium, CFGAG. http://www.genet.Sickkids.on.ca/cftr. Update Sept 08, 2006.
[12.]
M.N. Rafinia, L. Linde, B. Keron.
The CFTR gene: structure, mutations and specific therapeutic approaches.
CF in the 21st Century, pp. 2-10
[13.]
T.C. Senent.
pp. 29-43
[14.]
S. Rowe, S. Miller, E. Sarscher.
Mechanisms of disease Cystic Fibrosis.
New Eng J Med, 352 (2005), pp. 1992-1999
[15.]
M.P. Anderson, H.A. Berger, D.P. Rich, et al.
Nucleotide triphosphates are required to open CFRT-generated chloride channels.
Science, 253 (1991), pp. 205
[16.]
F. Ratjen, G. Doning.
Cystic Fibrosis.
[17.]
J. Gracia, F. Mata, A. Alvarez, T. Casals, et al.
Genothype-phenotype correlation for pulmonary function in Cystic Fibrosis.
Thorax, 60 (2005), pp. 558-563
[18.]
R. Dorfman, J. Ziclanski.
Genotype-fenotype correlations in CF.
CF in the 21st Century, pp. 61-68
[19.]
Pathophysiology and management of pulmonary infections in cystic fibrosis. Am J Resp Crit Care Med 2003; 168: 918-51.
[20.]
D.V. Schidlow, L.M. Taussing, M.R. Knowles.
Cystic fibrosis foundation consensus report on pulmonary complications of cystic fibrosis.
Pediatr Pulmonol, 15 (1993), pp. 187-198
[21.]
B.W. Ramsey.
Management of pulmonary disease in patients with Cystic Fibrosis.
N Eng J Med, 335 (1996), pp. 179-188
[22.]
G.G. Hernandez.
Patogenia in Monografias Neumo-Madrid.
Fibrosis Quística. Ergon., VIII (2005), pp. 45-55
[23.]
H. Shwachman, L.L. Kulczyky.
Long term study of one hundred five patients with cystic fibrosis studies made over stoll year period.
Am J Dis Child, 96 (1958), pp. 6-15
[24.]
M.A.N. Rodrigues, A.S. González.
Afectación respiratória en el niño Monografias NeumoMadrid.
Fibrosis Quística. Ergon., VIII (2005), pp. 79-90
[25.]
D. Reid, N.J. Withers, L. Francis, W. Wilson, T.C. Kotsimbos.
Iron deficiency in Cystic Fibrosis relationship to lung disease severity and chronic Pseudomonas aeruginosa infection.
Chest, 121 (2002), pp. 48-54
[26.]
J.J. Lipuma.
Burkholderia and emerging pathogens in Cystic Fibrosis.
Semin Resp Crit Care Med, 24 (2003), pp. 681
[27.]
D.V. Schidlow, L.M. Taussing, M.R. Knowles.
Cystic fibrosis foundation consensus report on pulmonary complications of cystic fibrosis.
Pediatr Pulmonol, 15 (1993), pp. 187-198
[28.]
C. Prados, L. Máiz, C. Antelo, F. Baranda, J. Blázquez, J.M. Borro, et al.
Fibrosis quística: consenso sobre el tratamiento del pneumotórax y de la hemoptisis massiva y sobre las indicaciones del transplante pulmonar.
Arch Bronconeumol, 36 (2000), pp. 411-416
[29.]
Monografías NeumoMadrid. vol VIII/2005 Fibrosis Quística. Martinez MTM, Herrero P A. Cap Complicaciones respiratórias no infecciosas más frequentes. pp. 99-111.
[30.]
G. Mastella, M. Rainisio, H.K. Harms, M.E. Hodson, C. Koch, J. Navarro, Allergic bronchopulmonary aspergillosis in cystic fibrosis. A European epidemiological study, et al.
Epidemiologic Registry of Cystic Fibrosis.
Eur Resp J, 16 (2000), pp. 464-471
[31.]
M.C.P. Sanchez, L.G. Camera, I.F. Navarro.
Afectación respiratória en el adulto Monografias NeumoMadrid.
Fibrosis Quística. Ergon., VIII (2005), pp. 91-98
[32.]
F. Lacaille, J. Schmitz.
Cystic Fibrosis.
Semin Pediatr Gastroenterolog Nutr, 4 (1993), pp. 1-15
[33.]
Monografías NeumoMadrid vol VIII/2005 Fibrosis Quística Moreno RMG, Posadas AS. Cap Manifestaciones digestivas. Novo MDG, Castillo CG, Manzanares J, pp. 113-130.
[34.]
J. Leus, S. Van Bervliet, E. Robberecht.
Detection and follow up of exocrine pancreatic insufficiency in cystic fibrosis: a review.
Eur J Pediatr, 159 (2000), pp. 563-568
[35.]
M. Gilljam, C. Chapman, E. Tullis, et al.
GI complications after lung transplantation in patients with Cystic Fibrosis.
Chest, 123 (2003), pp. 37
[36.]
C. Colombo.
Hepatology, 36 (2002), pp. 1374-1382
[37.]
Monografías NeumoMadrid vol VIII/2005 Fibrosis Quística Moreno RMG, Posadas AS. Cap Otras manifestaciones prevalentes. Moreno RMG, Posadas AS, Die go DSJ, pp. 131-139.
[38.]
E. Kerem, S. Conway, Elborn Stuart, H. Heijerman.
Standards of care for patients with cystic fibrosis: a European consensus.
Journal of Cystic Fibrosis, 4 (2005), pp. 7-26
[39.]
J.R. Yankaskas, B.C. Marshall, B. Sufian, R.H. Simon, D. Rodman.
Cystic Fibrosis Adult Care. Consensus Con ference Report.
Chest, 125 (2004), pp. 1S-39S
[40.]
J.A. Dodge.
Male fertility in cystic fibrosis.
Lancet, 346 (1995), pp. 587
[41.]
M. Chillon, T. Casals, B. Mercier, et al.
Mutations in Cystic Fibrosis gene in patients with congenital absence of vas deferens.
New Eng J Med, 332 (1995), pp. 1475
[42.]
J.J. McCallum, J.M. Milunsky, D.L. Cunningham.
Fertility in men with Cystic Fibrosis. An update on current surgical pratices ans outcomes.
Chest, 118 (2000), pp. 1059-1062
[43.]
M. Gilljam, M. Antonion, J. Shin, et al.
Pregnancy in Cystic Fibrosis. Fetal and maternal outcome.
Chest, 118 (2000), pp. 85
[44.]
C.S. Haworth, P.L. Selby, A.K. Webb, et al.
Low bone mineral density density in adults with Cystic Fibrosis.
Thorax, 54 (1999), pp. 961
[45.]
S.J. King, D.J. Topliss, Kotsimbos, et al.
Reduced bone density in Cystic Fibrosis. Delta F508 mutations is an independent risk factor.
Eur Resp J, 25 (2005), pp. 54
[46.]
Boeck K, Wilschanski M, Taylor C, Cuppens H, Dodge J, Sinaasappel M. Cystic fibrosis: terminology and diagnostic algorithms. Thorax 61:627-35.
[47.]
World Health Organisation.
Classification of cystic fibrosis and related disorders.
Report of a joint working group of WHO/ICF(M)/ECFS/ECFTN,
[48.]
L.E. Gibson, R.E. Cooke.
A test for concentration of electrolytes in sweat in cystic fibrosis of the pancreas utilizing pilocarpine by iontophoresis.
Pediatrics, 23 (1959), pp. 545-549
[49.]
Guidelines for the performance of the sweat test for the investigation of cystic fibrosis in the UK. Report from the multi-disciplinary working group. July 2002 (http:/www.acb.org.uk).
[50.]
Monografías NeumoMadrid vol VIII/2005 Fibrosis Quística Moreno R M G, Posadas A S. Cap Diagnóstico. Landeira C A, Aguero M I G, Carrasco M C M pág 141-54.
[51.]
B. Rosenstein, G. Cutting.
The diagnosis of Cystic Fibrosis: a consensus statement.
Journal of Pediatrics, 132 (1998), pp. 589-595
[52.]
M.P. Boyle, M. Dirner-West, L. Miljam, et al.
Multicenter study of the effect of solution temperature on nasal potential difference measurements.
Chest, 124 (2003), pp. 482
[53.]
I. Fajac, D. Hubert, D. Guillermot, et al.
Nasal airway ion transport is linked to the Cystic Fibrosis phenotype in adult patient.
[54.]
P. Robinson.
Paediatric origins of adult lung disease Thorax, 56 (2001), pp. 237-241
[55.]
A. Smith, S. Walters.
Prophylactic antibiotics for Cystic Fibrosis.
Cochrane Database Syst Rev, (2003),
[56.]
K. McCaffery, R.E. Oliver, M. Franklin, et al.
Systematic review of anti-staphylococcal antibiotherapy in Cystic Fibrosis.
Thorax, 54 (1999), pp. 380-383
[57.]
R. Cantón, N. Cobos, J. Gracia, F. Baquero, et al.
Tratamiento antimicrobiano frente a la colonización pulmonar por Pseudomonas aeruginosa en el paciente com fibrose quistica.
Archivos de Bronconeumologia, 41 (2005), pp. 1-25
[58.]
B.W. Ramsey, J. Burns, A.L. Smith.
Safety and efficacy of tobramycin solution for inhalation in patients with cystic fibrosis.
The results of 2 phases placebo controlled trials. Pediatr Pulmonol, 14 (1997), pp. 137-138
[59.]
B.W. Ramsey, M.S. Pepe, J.M. Quan, et al.
Intermittent administration of inhaled tobramycin in patients with cystic fibrosis.
N England J Med, 340 (1999), pp. 23-30
[60.]
M. Nir, S. Lanng, H.K. Johansen, C. Koch.
Long-term survival and nutrional data in patients with cystic fibrosis treated in a Danish centre.
Thorax, 51 (1996), pp. 1023-1027
[61.]
L.J. Kettler, S.M. Sawyer, H.R. Winefield, H.W. Greville.
Determinants of adherence in adults with Cystic Fibrosis.
Thorax, 57 (2002), pp. 459-464
[62.]
G. Pico.
Aerosolized antibiotics.
Chest, (1998),
[63.]
M.R. Elkeis, M. Robinson, B.R. Rose, C. Harbour, et al.
Controlled trial of long term inhaled hypertonic saline in patients with Cystic Fibrosis.
N Eng J Med, 356 (2006), pp. 229-240
[64.]
P.J. Wijkastra, G.H. Guyatt, N. Ambrosino, B.R. Celli, R. Guell, J.F. Muir, et al.
International approaches to the prescription of long-term oxygen.
Eur Respir J, 18 (2001), pp. 909-913
[65.]
J.A. Wedziche, J.F. Muir.
Non-invasive ventilation in Chronic Obstructive Pulmonary disease.
Bronquiectasis and Cystic Fibrosis. Eur Respir J, 20 (2002), pp. 777-784
[66.]
A.P. Jones, C.E. Wallis.
Recombinant Deoxiribonuclease for Cystic Fibrosis.
Cochrane Database Syst Rev, 2 (2000), pp. CD001127
[67.]
L. Sainan, B. Marshall, N. Mayer-Hemblet, et al.
Azithromycin in patients with cystic Fibrosis chronically infected with Pseudomonas aeruginosa. A randomized controlled trial.
JAMA, 290 (2003), pp. 1749-1756
[68.]
J.R. Yankaskas, Mallory GB and Consensus Committee.
Lung transplantation in Cystic Fibrosis.
Chest, 113 (1998), pp. 217-226
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