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Journal Information
Vol. 15. Issue 6.
Pages 1185-1191 (November - December 2009)
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Vol. 15. Issue 6.
Pages 1185-1191 (November - December 2009)
Caso Clínico/Case Report
Open Access
A asma e os seus diagnósticos diferenciais
Asthma and its differential diagnoses
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5836
Alexandra Bento1,
Corresponding author
alexitbento@gmail.com

Centro Hospitalar de Coimbra EPE, Serviço de Pneumologia, São Martinho do Bispo, 3000 Coimbra.
, Ana Maria Arrobas2
1 Interna do Internato Complementar de Pneumologia da Unidade de Saúde Local EPE Guarda
2 Assistente Hospitalar Graduada de Pneumologia do Centro Hospitalar de Coimbra, EPE
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Resumo

A aspergilose broncopulmonar alérgica (ABPA) ocorre em doentes não imunocomprometidos e é uma patologia de hipersensibilidade induzida pelo Aspergillus5.

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 infância1.

O diagnóstico baseia-se na presença de uma combinação de critérios clínicos, biológicos e radiológicos5. 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 pulmonar1.

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.

Rev Port Pneumol 2009; XV (6): 1185-1191

Palavras-chave:
Asma
aspergilose broncopulmonar alérgica
critérios de diagnóstico
Abstract

Allergic bronchopulmonary aspergillosis (ABPA) occurs in immunocompetent patients and belongs to the Aspergillus5 induced hypersensitivity disorders.

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.

A diagnosis of ABPA is based on a combination of clinical, biological and radiology criteria4.

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.

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.

Rev Port Pneumol 2009; XV (6): 1185-1191

Key-words:
Asthma
allergic bronchopulmonary aspergillosis
diagnostic guidelines
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Bibliografia
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Tratado de Neumología.
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Allergic bronchopulmonary aspergillosis.
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Allergy & clinical immunology; allergic bronchopulmonary aspergillosis, (2008),
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Allergic bronchopulmonary aspergillosis: challenges in diagnosis.
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J. Collins, et al.
Allergic bronchopulmonary aspergillosis treated successfully with omalizumab: three case reports.
Ann Alllergy Asthma Immunol, 100 (2008), pp. A7
[10.]
Adaobi Kanu, et al.
Treatment of allergic bronchopulmonary aspergillosis (ABPA) in CF with anti-IgE antibody (omalizumab).
Pediatric Pulmonology, 43 (2008), pp. 1249-1251
Copyright © 2009. Sociedade Portuguesa de Pneumologia/SPP
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