array:23 [
  "pii" => "S1579212906601481"
  "issn" => "15792129"
  "doi" => "10.1016/S1579-2129(06)60148-1"
  "estado" => "S300"
  "fechaPublicacion" => "2006-06-01"
  "aid" => "60148"
  "copyright" => "Sociedad Española de Neumología y Cirugía Torácica (SEPAR)"
  "copyrightAnyo" => "2006"
  "documento" => "article"
  "crossmark" => 0
  "subdocumento" => "sco"
  "cita" => "Arch Bronconeumol. 2006;42:307-9"
  "abierto" => array:3 [
    "ES" => false
    "ES2" => false
    "LATM" => false
  ]
  "gratuito" => false
  "lecturas" => array:2 [
    "total" => 3797
    "formatos" => array:3 [
      "EPUB" => 114
      "HTML" => 3000
      "PDF" => 683
    ]
  ]
  "itemSiguiente" => array:18 [
    "pii" => "S1579212906601493"
    "issn" => "15792129"
    "doi" => "10.1016/S1579-2129(06)60149-3"
    "estado" => "S300"
    "fechaPublicacion" => "2006-06-01"
    "aid" => "60149"
    "copyright" => "Sociedad Española de Neumología y Cirugía Torácica (SEPAR)"
    "documento" => "simple-article"
    "crossmark" => 0
    "subdocumento" => "cor"
    "cita" => "Arch Bronconeumol. 2006;42:310"
    "abierto" => array:3 [
      "ES" => false
      "ES2" => false
      "LATM" => false
    ]
    "gratuito" => false
    "lecturas" => array:2 [
      "total" => 1743
      "formatos" => array:3 [
        "EPUB" => 94
        "HTML" => 1068
        "PDF" => 581
      ]
    ]
    "en" => array:8 [
      "idiomaDefecto" => true
      "cabecera" => "<span class="elsevierStyleTextfn">Letters to the Editor</span>"
      "titulo" => "Validation of a Method for Predicting Risk of Poor Outcome in Patients With Pulmonary Thromboembolism"
      "tienePdf" => "en"
      "tieneTextoCompleto" => 0
      "paginas" => array:1 [
        0 => array:1 [
          "paginaInicial" => "310"
        ]
      ]
      "contienePdf" => array:1 [
        "en" => true
      ]
      "autores" => array:1 [
        0 => array:2 [
          "autoresLista" => "Jos&#233; Mar&#237;a Calvo Romero, Esther Mar&#237;a Lima Rodr&#237;guez"
          "autores" => array:2 [
            0 => array:2 [
              "nombre" => "Jos&#233;"
              "apellidos" => "Mar&#237;a Calvo Romero"
            ]
            1 => array:2 [
              "nombre" => "Esther"
              "apellidos" => "Mar&#237;a Lima Rodr&#237;guez"
            ]
          ]
        ]
      ]
    ]
    "idiomaDefecto" => "en"
    "EPUB" => "https://multimedia.elsevier.es/PublicationsMultimediaV1/item/epub/S1579212906601493?idApp=UINPBA00003Z"
    "url" => "/15792129/0000004200000006/v1_201305150246/S1579212906601493/v1_201305150246/en/main.assets"
  ]
  "itemAnterior" => array:18 [
    "pii" => "S157921290660147X"
    "issn" => "15792129"
    "doi" => "10.1016/S1579-2129(06)60147-X"
    "estado" => "S300"
    "fechaPublicacion" => "2006-06-01"
    "aid" => "60147"
    "copyright" => "Sociedad Espa&#241;ola de Neumolog&#237;a y Cirug&#237;a Tor&#225;cica &#40;SEPAR&#41;"
    "documento" => "article"
    "crossmark" => 0
    "subdocumento" => "sco"
    "cita" => "Arch Bronconeumol. 2006;42:302-6"
    "abierto" => array:3 [
      "ES" => false
      "ES2" => false
      "LATM" => false
    ]
    "gratuito" => false
    "lecturas" => array:2 [
      "total" => 2624
      "formatos" => array:3 [
        "EPUB" => 108
        "HTML" => 1806
        "PDF" => 710
      ]
    ]
    "en" => array:10 [
      "idiomaDefecto" => true
      "cabecera" => "<span class="elsevierStyleTextfn">Case Reports</span>"
      "titulo" => "Occupational Asthma Caused by Chromium and Nickel"
      "tienePdf" => "en"
      "tieneTextoCompleto" => 0
      "tieneResumen" => array:2 [
        0 => "en"
        1 => "es"
      ]
      "paginas" => array:1 [
        0 => array:2 [
          "paginaInicial" => "302"
          "paginaFinal" => "306"
        ]
      ]
      "contieneResumen" => array:2 [
        "en" => true
        "es" => true
      ]
      "contienePdf" => array:1 [
        "en" => true
      ]
      "autores" => array:1 [
        0 => array:2 [
          "autoresLista" => "Mar&#237;a Jesus Cruz, Roser Costa, Eduard Marquilles, Ferran Morell, Xavier Mu&#241;oz"
          "autores" => array:5 [
            0 => array:2 [
              "nombre" => "Mar&#237;a"
              "apellidos" => "Jesus Cruz"
            ]
            1 => array:2 [
              "nombre" => "Roser"
              "apellidos" => "Costa"
            ]
            2 => array:2 [
              "nombre" => "Eduard"
              "apellidos" => "Marquilles"
            ]
            3 => array:2 [
              "nombre" => "Ferran"
              "apellidos" => "Morell"
            ]
            4 => array:3 [
              "preGrado" => "Dr&#46;"
              "nombre" => "Xavier"
              "apellidos" => "Mu&#241;oz"
            ]
          ]
        ]
      ]
    ]
    "idiomaDefecto" => "en"
    "EPUB" => "https://multimedia.elsevier.es/PublicationsMultimediaV1/item/epub/S157921290660147X?idApp=UINPBA00003Z"
    "url" => "/15792129/0000004200000006/v1_201305150246/S157921290660147X/v1_201305150246/en/main.assets"
  ]
  "en" => array:14 [
    "idiomaDefecto" => true
    "cabecera" => "<span class="elsevierStyleTextfn">Case Reports</span>"
    "titulo" => "Bilateral Hemothorax Secondary to Combined Antiplatelet Therapy With Clopidogrel and Acetylsalicylic Acid"
    "tieneTextoCompleto" => 0
    "paginas" => array:1 [
      0 => array:2 [
        "paginaInicial" => "307"
        "paginaFinal" => "309"
      ]
    ]
    "autores" => array:1 [
      0 => array:4 [
        "autoresLista" => "Manuel Haro Estarriol, Luis Alberto &#193;lvarez Castillo, Xavier Bald&#243; Padr&#243;, Anna Palou Rispau, Matilde Rubio Garay, Manel Rubio Goday"
        "autores" => array:6 [
          0 => array:5 [
            "preGrado" => "Dr&#46;"
            "nombre" => "Manuel"
            "apellidos" => "Haro Estarriol"
            "email" => array:1 [
              0 => "mip&#46;mharo&#64;htrueta&#46;scs&#46;es"
            ]
            "referencia" => array:2 [
              0 => array:2 [
                "etiqueta" => "<span class="elsevierStyleSup">a</span>"
                "identificador" => "aff1"
              ]
              1 => array:2 [
                "etiqueta" => "<span class="elsevierStyleSup">&#42;</span>"
                "identificador" => "cor1"
              ]
            ]
          ]
          1 => array:3 [
            "nombre" => "Luis"
            "apellidos" => "Alberto &#193;lvarez Castillo"
            "referencia" => array:1 [
              0 => array:2 [
                "etiqueta" => "<span class="elsevierStyleSup">a</span>"
                "identificador" => "aff1"
              ]
            ]
          ]
          2 => array:3 [
            "nombre" => "Xavier"
            "apellidos" => "Bald&#243; Padr&#243;"
            "referencia" => array:1 [
              0 => array:2 [
                "etiqueta" => "<span class="elsevierStyleSup">b</span>"
                "identificador" => "aff2"
              ]
            ]
          ]
          3 => array:3 [
            "nombre" => "Anna"
            "apellidos" => "Palou Rispau"
            "referencia" => array:1 [
              0 => array:2 [
                "etiqueta" => "<span class="elsevierStyleSup">a</span>"
                "identificador" => "aff1"
              ]
            ]
          ]
          4 => array:3 [
            "nombre" => "Matilde"
            "apellidos" => "Rubio Garay"
            "referencia" => array:1 [
              0 => array:2 [
                "etiqueta" => "<span class="elsevierStyleSup">b</span>"
                "identificador" => "aff2"
              ]
            ]
          ]
          5 => array:3 [
            "nombre" => "Manel"
            "apellidos" => "Rubio Goday"
            "referencia" => array:1 [
              0 => array:2 [
                "etiqueta" => "<span class="elsevierStyleSup">a</span>"
                "identificador" => "aff1"
              ]
            ]
          ]
        ]
        "afiliaciones" => array:2 [
          0 => array:3 [
            "entidad" => "Secci&#243;n de Neumolog&#237;a&#44; Hospital Universitario de Girona Doctor Josep Trueta&#44; Girona&#44; Spain"
            "etiqueta" => "<span class="elsevierStyleSup">a</span>"
            "identificador" => "aff1"
          ]
          1 => array:3 [
            "entidad" => "Servicio de Cirug&#237;a Tor&#225;cica&#44; Hospital Universitario de Girona Doctor Josep Trueta&#44; Girona&#44; Spain"
            "etiqueta" => "<span class="elsevierStyleSup">b</span>"
            "identificador" => "aff2"
          ]
        ]
        "correspondencia" => array:1 [
          0 => array:3 [
            "identificador" => "cor1"
            "etiqueta" => "&#42;"
            "correspondencia" => "Correspondence&#58; Dr&#46; M&#46; Haro Estarriol&#46; Secci&#243;n de Neumolog&#237;a &#40;Planta 4&#46;<span class="elsevierStyleSup">a</span> B&#41;&#46; Hospital Universitario de Girona Doctor Josep Trueta&#46; Avda&#46; de Francia&#44; s&#47;n&#46; 17007 Girona&#46; Espa&#241;a"
          ]
        ]
      ]
    ]
    "pdfFichero" => "main.pdf"
    "tienePdf" => true
    "fechaRecibido" => "2005-08-23"
    "fechaAceptado" => "2005-09-06"
    "PalabrasClave" => array:2 [
      "en" => array:1 [
        0 => array:4 [
          "clase" => "keyword"
          "titulo" => "Key words"
          "identificador" => "xpalclavsec154409"
          "palabras" => array:3 [
            0 => "Clopidogrel"
            1 => "Acetylsalicylic acid"
            2 => "Hemothorax"
          ]
        ]
      ]
      "es" => array:1 [
        0 => array:4 [
          "clase" => "keyword"
          "titulo" => "Palabras clave"
          "identificador" => "xpalclavsec154408"
          "palabras" => array:3 [
            0 => "Clopidogrel"
            1 => "&#193;cido acetilsalic&#237;lico"
            2 => "Hemot&#243;rax"
          ]
        ]
      ]
    ]
    "tieneResumen" => true
    "resumen" => array:2 [
      "en" => array:1 [
        "resumen" => "<p class="elsevierStyleSimplePara elsevierViewall">Clopidogrel is a platelet aggregation inhibitor that increases the risk of bleeding complications when combined with acetylsalicylic acid&#46; We report a rare case of a 79-year-old male treated with clopidogrel and acetylsalicylic acid after coronary angioplasty and stenting to treat unstable angina&#46; Two months after initiation of therapy&#44; the patient presented with symptomatic bilateral pleural effusion&#46; Examination of both effusions confirmed the diagnosis of spontaneous bilateral hemothorax due to combined antiplatelet therapy&#46; Serious functional sequelae were still present 18 months after diagnosis despite bilateral pleural drainage and respiratory therapy&#46;</p>"
      ]
      "es" => array:1 [
        "resumen" => "<p class="elsevierStyleSimplePara elsevierViewall">El clopidogrel es un inhibidor de la agregaci&#243;n plaquetaria que aumenta el riesgo de complicaciones hemorr&#225;gicas cuando se combina con el &#225;cido acetilsalic&#237;lico&#46; Presentamos un caso excepcional en un var&#243;n de 79 a&#241;os tratado con clopidogrel y &#225;cido acetilsalic&#237;lico despu&#233;s de una angioplastia coronaria y la colocaci&#243;n de un <span class="elsevierStyleItalic">stent</span> por una angina inestable&#46; A los 2 meses de tratamiento present&#243; un derrame pleural bilateral sintom&#225;tico&#46; El estudio de ambos derrames confirm&#243; el diagn&#243;stico de un hemot&#243;rax espont&#225;neo bilateral atribuido a los antiagregantes&#46; El drenaje pleural bilateral y la fisioterapia respiratoria no impidieron la persistencia de importantes secuelas funcionales a los 18 meses del diagn&#243;stico&#46;</p>"
      ]
    ]
    "bibliografia" => array:2 [
      "titulo" => "REFERENCES"
      "seccion" => array:1 [
        0 => array:1 [
          "bibliografiaReferencia" => array:18 [
            0 => array:3 [
              "identificador" => "bib1"
              "etiqueta" => "1"
              "referencia" => array:1 [
                0 => array:2 [
                  "contribucion" => array:1 [
                    0 => array:2 [
                      "titulo" => "Ticlopidine and clopidogrel"
                      "autores" => array:1 [
                        0 => array:2 [
                          "etal" => false
                          "autores" => array:2 [
                            0 => "MJ Quinn"
                            1 => "DJ Fitzgerald"
                          ]
                        ]
                      ]
                    ]
                  ]
                  "host" => array:1 [
                    0 => array:1 [
                      "Revista" => array:6 [
                        "tituloSerie" => "Circulation"
                        "fecha" => "1999"
                        "volumen" => "100"
                        "paginaInicial" => "1667"
                        "paginaFinal" => "1672"
                        "link" => array:1 [
                          0 => array:2 [
                            "url" => "https://www.ncbi.nlm.nih.gov/pubmed/10517740"
                            "web" => "Medline"
                          ]
                        ]
                      ]
                    ]
                  ]
                ]
              ]
            ]
            1 => array:3 [
              "identificador" => "bib2"
              "etiqueta" => "2"
              "referencia" => array:1 [
                0 => array:2 [
                  "contribucion" => array:1 [
                    0 => array:2 [
                      "titulo" => "A randomised&#44; blinded&#44; trial of clopidogrel versus aspirin in patients at risk of ischaemic events &#40;CAPRIE&#41;"
                      "autores" => array:1 [
                        0 => array:2 [
                          "colaboracion" => "CAPRIE Steering Committee"
                          "etal" => false
                        ]
                      ]
                    ]
                  ]
                  "host" => array:1 [
                    0 => array:1 [
                      "Revista" => array:6 [
                        "tituloSerie" => "Lancet"
                        "fecha" => "1996"
                        "volumen" => "348"
                        "paginaInicial" => "1329"
                        "paginaFinal" => "1339"
                        "link" => array:1 [
                          0 => array:2 [
                            "url" => "https://www.ncbi.nlm.nih.gov/pubmed/8918275"
                            "web" => "Medline"
                          ]
                        ]
                      ]
                    ]
                  ]
                ]
              ]
            ]
            2 => array:3 [
              "identificador" => "bib3"
              "etiqueta" => "3"
              "referencia" => array:1 [
                0 => array:2 [
                  "contribucion" => array:1 [
                    0 => array:2 [
                      "titulo" => "Collaborative metaanalysis of randomised trials of antiplatelet therapy for prevention of death&#44; myocardial infraction and stroke in high risk patients"
                      "autores" => array:1 [
                        0 => array:2 [
                          "colaboracion" => "Antithrombotic Trialists&#39; Collaboration"
                          "etal" => false
                        ]
                      ]
                    ]
                  ]
                  "host" => array:1 [
                    0 => array:1 [
                      "Revista" => array:5 [
                        "tituloSerie" => "Lancet"
                        "fecha" => "2002"
                        "volumen" => "324"
                        "paginaInicial" => "71"
                        "paginaFinal" => "86"
                      ]
                    ]
                  ]
                ]
              ]
            ]
            3 => array:3 [
              "identificador" => "bib4"
              "etiqueta" => "4"
              "referencia" => array:1 [
                0 => array:2 [
                  "contribucion" => array:1 [
                    0 => array:2 [
                      "titulo" => "Effects of clopidogrel in addition to aspirin in patients with acute coronary syndromes without ST-segment elevation"
                      "autores" => array:1 [
                        0 => array:2 [
                          "colaboracion" => "The Clopidogrel in Unstable Angina to Prevent Recurrent Events Trial investigators"
                          "etal" => false
                        ]
                      ]
                    ]
                  ]
                  "host" => array:1 [
                    0 => array:2 [
                      "doi" => "10.1056/NEJMoa010746"
                      "Revista" => array:6 [
                        "tituloSerie" => "N Engl J Med"
                        "fecha" => "2001"
                        "volumen" => "345"
                        "paginaInicial" => "494"
                        "paginaFinal" => "502"
                        "link" => array:1 [
                          0 => array:2 [
                            "url" => "https://www.ncbi.nlm.nih.gov/pubmed/11519503"
                            "web" => "Medline"
                          ]
                        ]
                      ]
                    ]
                  ]
                ]
              ]
            ]
            4 => array:3 [
              "identificador" => "bib5"
              "etiqueta" => "5"
              "referencia" => array:1 [
                0 => array:2 [
                  "contribucion" => array:1 [
                    0 => array:2 [
                      "titulo" => "The effect of clopidogrel in combination with aspirin when given before coronary artery bypass grafting"
                      "autores" => array:1 [
                        0 => array:2 [
                          "etal" => false
                          "autores" => array:3 [
                            0 => "RH Hongo"
                            1 => "J Ley"
                            2 => "SE Dick"
                          ]
                        ]
                      ]
                    ]
                  ]
                  "host" => array:1 [
                    0 => array:1 [
                      "Revista" => array:6 [
                        "tituloSerie" => "J Am Coll Cardiol"
                        "fecha" => "2002"
                        "volumen" => "40"
                        "paginaInicial" => "231"
                        "paginaFinal" => "237"
                        "link" => array:1 [
                          0 => array:2 [
                            "url" => "https://www.ncbi.nlm.nih.gov/pubmed/12106925"
                            "web" => "Medline"
                          ]
                        ]
                      ]
                    ]
                  ]
                ]
              ]
            ]
            5 => array:3 [
              "identificador" => "bib6"
              "etiqueta" => "6"
              "referencia" => array:1 [
                0 => array:2 [
                  "contribucion" => array:1 [
                    0 => array:2 [
                      "titulo" => "Hemorragia subaracnoidea y clopidrogel"
                      "autores" => array:1 [
                        0 => array:2 [
                          "etal" => false
                          "autores" => array:4 [
                            0 => "JJ Ib&#225;&#241;ez"
                            1 => "M Nolla"
                            2 => "MA Le&#243;n"
                            3 => "MC Mart&#237;n"
                          ]
                        ]
                      ]
                    ]
                  ]
                  "host" => array:1 [
                    0 => array:1 [
                      "Revista" => array:5 [
                        "tituloSerie" => "Med Clin &#40;Barc&#41;"
                        "fecha" => "2002"
                        "volumen" => "119"
                        "paginaInicial" => "158"
                        "paginaFinal" => "159"
                      ]
                    ]
                  ]
                ]
              ]
            ]
            6 => array:3 [
              "identificador" => "bib7"
              "etiqueta" => "7"
              "referencia" => array:1 [
                0 => array:2 [
                  "contribucion" => array:1 [
                    0 => array:2 [
                      "titulo" => "Massive pulmonary haemorrhage complicating the treatment of acute coronary syndrome"
                      "autores" => array:1 [
                        0 => array:2 [
                          "etal" => false
                          "autores" => array:3 [
                            0 => "DS Gill"
                            1 => "K Ng"
                            2 => "KS Ng"
                          ]
                        ]
                      ]
                    ]
                  ]
                  "host" => array:1 [
                    0 => array:1 [
                      "Revista" => array:4 [
                        "tituloSerie" => "Heart"
                        "fecha" => "2004"
                        "volumen" => "90"
                        "paginaInicial" => "15"
                      ]
                    ]
                  ]
                ]
              ]
            ]
            7 => array:3 [
              "identificador" => "bib8"
              "etiqueta" => "8"
              "referencia" => array:1 [
                0 => array:2 [
                  "contribucion" => array:1 [
                    0 => array:2 [
                      "titulo" => "Diffuse alveolar hemorrhage after clopidogrel use"
                      "autores" => array:1 [
                        0 => array:2 [
                          "etal" => false
                          "autores" => array:4 [
                            0 => "PK Kilaru"
                            1 => "MJ Schweiger"
                            2 => "HA Kozman"
                            3 => "TR Weil"
                          ]
                        ]
                      ]
                    ]
                  ]
                  "host" => array:1 [
                    0 => array:1 [
                      "Revista" => array:6 [
                        "tituloSerie" => "J Invasive Cardiol"
                        "fecha" => "2001"
                        "volumen" => "13"
                        "paginaInicial" => "535"
                        "paginaFinal" => "537"
                        "link" => array:1 [
                          0 => array:2 [
                            "url" => "https://www.ncbi.nlm.nih.gov/pubmed/11435642"
                            "web" => "Medline"
                          ]
                        ]
                      ]
                    ]
                  ]
                ]
              ]
            ]
            8 => array:3 [
              "identificador" => "bib9"
              "etiqueta" => "9"
              "referencia" => array:1 [
                0 => array:2 [
                  "contribucion" => array:1 [
                    0 => array:2 [
                      "titulo" => "Hemothorax"
                      "autores" => array:1 [
                        0 => array:2 [
                          "etal" => false
                          "autores" => array:2 [
                            0 => "RC Jacoby"
                            1 => "FD Battistella"
                          ]
                        ]
                      ]
                    ]
                  ]
                  "host" => array:1 [
                    0 => array:2 [
                      "doi" => "10.1055/s-2001-18798"
                      "Revista" => array:6 [
                        "tituloSerie" => "Semin Respir Crit Care Med"
                        "fecha" => "2001"
                        "volumen" => "22"
                        "paginaInicial" => "627"
                        "paginaFinal" => "630"
                        "link" => array:1 [
                          0 => array:2 [
                            "url" => "https://www.ncbi.nlm.nih.gov/pubmed/16088706"
                            "web" => "Medline"
                          ]
                        ]
                      ]
                    ]
                  ]
                ]
              ]
            ]
            9 => array:3 [
              "identificador" => "bib10"
              "etiqueta" => "10"
              "referencia" => array:1 [
                0 => array:2 [
                  "contribucion" => array:1 [
                    0 => array:2 [
                      "titulo" => "Estudio prospectivo de 1&#46;000 pacientes consecutivos con derrame pleural"
                      "autores" => array:1 [
                        0 => array:2 [
                          "etal" => false
                          "autores" => array:5 [
                            0 => "V Villena"
                            1 => "A L&#243;pez"
                            2 => "J Echave"
                            3 => "C &#225;lvarez"
                            4 => "P Mart&#237;n"
                          ]
                        ]
                      ]
                    ]
                  ]
                  "host" => array:1 [
                    0 => array:1 [
                      "Revista" => array:5 [
                        "tituloSerie" => "Etiolog&#237;a del derrame y caracter&#237;sticas de los pacientes&#46; Arch Bronconeumol"
                        "fecha" => "2002"
                        "volumen" => "38"
                        "paginaInicial" => "21"
                        "paginaFinal" => "26"
                      ]
                    ]
                  ]
                ]
              ]
            ]
            10 => array:3 [
              "identificador" => "bib11"
              "etiqueta" => "11"
              "referencia" => array:1 [
                0 => array:2 [
                  "contribucion" => array:1 [
                    0 => array:2 [
                      "titulo" => "Hemot&#243;rax espont&#225;neo por rotura de aneurisma de arteria pulmonar en la enfermedad de Rendu-Osler"
                      "autores" => array:1 [
                        0 => array:2 [
                          "etal" => false
                          "autores" => array:3 [
                            0 => "P Aus&#237;n"
                            1 => "A G&#243;mez"
                            2 => "FJ Moradiellos"
                          ]
                        ]
                      ]
                    ]
                  ]
                  "host" => array:1 [
                    0 => array:1 [
                      "Revista" => array:6 [
                        "tituloSerie" => "Arch Bronconeumol"
                        "fecha" => "2004"
                        "volumen" => "40"
                        "paginaInicial" => "602"
                        "paginaFinal" => "603"
                        "link" => array:1 [
                          0 => array:2 [
                            "url" => "https://www.ncbi.nlm.nih.gov/pubmed/15574277"
                            "web" => "Medline"
                          ]
                        ]
                      ]
                    ]
                  ]
                ]
              ]
            ]
            11 => array:3 [
              "identificador" => "bib12"
              "etiqueta" => "12"
              "referencia" => array:1 [
                0 => array:2 [
                  "contribucion" => array:1 [
                    0 => array:2 [
                      "titulo" => "Hemot&#243;rax como forma de presentaci&#243;n de angiosarcoma card&#237;aco"
                      "autores" => array:1 [
                        0 => array:2 [
                          "etal" => false
                          "autores" => array:3 [
                            0 => "JM Barreiro"
                            1 => "V Leiro"
                            2 => "L Pi&#241;ero"
                          ]
                        ]
                      ]
                    ]
                  ]
                  "host" => array:1 [
                    0 => array:1 [
                      "Revista" => array:5 [
                        "tituloSerie" => "Arch Bronconeumol"
                        "fecha" => "2005"
                        "volumen" => "41"
                        "paginaInicial" => "105"
                        "link" => array:1 [
                          0 => array:2 [
                            "url" => "https://www.ncbi.nlm.nih.gov/pubmed/15718008"
                            "web" => "Medline"
                          ]
                        ]
                      ]
                    ]
                  ]
                ]
              ]
            ]
            12 => array:3 [
              "identificador" => "bib13"
              "etiqueta" => "13"
              "referencia" => array:1 [
                0 => array:2 [
                  "contribucion" => array:1 [
                    0 => array:2 [
                      "titulo" => "Hemot&#243;rax espont&#225;neo por carcinoma broncog&#233;nico"
                      "autores" => array:1 [
                        0 => array:2 [
                          "etal" => false
                          "autores" => array:6 [
                            0 => "P Aus&#237;n"
                            1 => "A G&#243;mez"
                            2 => "R P&#233;rez"
                            3 => "FJ Moradiellos"
                            4 => "V D&#237;az"
                            5 => "JL Mart&#237;n"
                          ]
                        ]
                      ]
                    ]
                  ]
                  "host" => array:1 [
                    0 => array:1 [
                      "Revista" => array:6 [
                        "tituloSerie" => "Arch Bronconeumol"
                        "fecha" => "2005"
                        "volumen" => "41"
                        "paginaInicial" => "400"
                        "paginaFinal" => "401"
                        "link" => array:1 [
                          0 => array:2 [
                            "url" => "https://www.ncbi.nlm.nih.gov/pubmed/16029735"
                            "web" => "Medline"
                          ]
                        ]
                      ]
                    ]
                  ]
                ]
              ]
            ]
            13 => array:3 [
              "identificador" => "bib14"
              "etiqueta" => "14"
              "referencia" => array:1 [
                0 => array:2 [
                  "contribucion" => array:1 [
                    0 => array:2 [
                      "titulo" => "Spontaneous hemothorax&#46; Report of 6 cases and review of the literature"
                      "autores" => array:1 [
                        0 => array:2 [
                          "etal" => false
                          "autores" => array:5 [
                            0 => "FJ Mart&#237;nez"
                            1 => "AG Villanueva"
                            2 => "R Pickering"
                            3 => "FS Becker"
                            4 => "DR Smith"
                          ]
                        ]
                      ]
                    ]
                  ]
                  "host" => array:1 [
                    0 => array:1 [
                      "Revista" => array:5 [
                        "tituloSerie" => "Medicine &#40;Baltimore&#41;"
                        "fecha" => "1993"
                        "volumen" => "71"
                        "paginaInicial" => "354"
                        "paginaFinal" => "368"
                      ]
                    ]
                  ]
                ]
              ]
            ]
            14 => array:3 [
              "identificador" => "bib15"
              "etiqueta" => "15"
              "referencia" => array:1 [
                0 => array:2 [
                  "contribucion" => array:1 [
                    0 => array:2 [
                      "titulo" => "Hemothorax after Lupron therapy of a patient with pleural endometriosis&#46; A case report and literature review"
                      "autores" => array:1 [
                        0 => array:2 [
                          "etal" => false
                          "autores" => array:4 [
                            0 => "MT Margolis"
                            1 => "LD Thoen"
                            2 => "LJ Mercer"
                            3 => "LG Keith"
                          ]
                        ]
                      ]
                    ]
                  ]
                  "host" => array:1 [
                    0 => array:1 [
                      "Revista" => array:5 [
                        "tituloSerie" => "Int J Fertil"
                        "fecha" => "1996"
                        "volumen" => "41"
                        "paginaInicial" => "53"
                        "paginaFinal" => "55"
                      ]
                    ]
                  ]
                ]
              ]
            ]
            15 => array:3 [
              "identificador" => "bib16"
              "etiqueta" => "16"
              "referencia" => array:1 [
                0 => array:2 [
                  "contribucion" => array:1 [
                    0 => array:2 [
                      "titulo" => "Delayed traumatic hemothorax on ticlopidine"
                      "autores" => array:1 [
                        0 => array:2 [
                          "etal" => false
                          "autores" => array:2 [
                            0 => "MW Quinn"
                            1 => "TA Dillard"
                          ]
                        ]
                      ]
                    ]
                  ]
                  "host" => array:1 [
                    0 => array:1 [
                      "Revista" => array:6 [
                        "tituloSerie" => "Chest"
                        "fecha" => "1999"
                        "volumen" => "116"
                        "paginaInicial" => "257"
                        "paginaFinal" => "260"
                        "link" => array:1 [
                          0 => array:2 [
                            "url" => "https://www.ncbi.nlm.nih.gov/pubmed/10424539"
                            "web" => "Medline"
                          ]
                        ]
                      ]
                    ]
                  ]
                ]
              ]
            ]
            16 => array:3 [
              "identificador" => "bib17"
              "etiqueta" => "17"
              "referencia" => array:1 [
                0 => array:2 [
                  "contribucion" => array:1 [
                    0 => array:2 [
                      "titulo" => "A feasibility study of the safety and efficacy of a combined clopidogrel and aspirin regimen following off-pump coronary artery bypass grafting"
                      "autores" => array:1 [
                        0 => array:2 [
                          "etal" => false
                          "autores" => array:3 [
                            0 => "H Shennib"
                            1 => "M Endo"
                            2 => "O Benhameid"
                          ]
                        ]
                      ]
                    ]
                  ]
                  "host" => array:1 [
                    0 => array:1 [
                      "Revista" => array:6 [
                        "tituloSerie" => "Heart Surg Forum"
                        "fecha" => "2003"
                        "volumen" => "6"
                        "paginaInicial" => "288"
                        "paginaFinal" => "291"
                        "link" => array:1 [
                          0 => array:2 [
                            "url" => "https://www.ncbi.nlm.nih.gov/pubmed/14721795"
                            "web" => "Medline"
                          ]
                        ]
                      ]
                    ]
                  ]
                ]
              ]
            ]
            17 => array:3 [
              "identificador" => "bib18"
              "etiqueta" => "18"
              "referencia" => array:1 [
                0 => array:2 [
                  "contribucion" => array:1 [
                    0 => array:2 [
                      "titulo" => "Alveolar hemorrhage as a complication of treatment with abciximab"
                      "autores" => array:1 [
                        0 => array:2 [
                          "etal" => false
                          "autores" => array:3 [
                            0 => "S Kalra"
                            1 => "MR Bell"
                            2 => "CS Rihal"
                          ]
                        ]
                      ]
                    ]
                  ]
                  "host" => array:1 [
                    0 => array:1 [
                      "Revista" => array:6 [
                        "tituloSerie" => "Chest"
                        "fecha" => "2001"
                        "volumen" => "120"
                        "paginaInicial" => "126"
                        "paginaFinal" => "131"
                        "link" => array:1 [
                          0 => array:2 [
                            "url" => "https://www.ncbi.nlm.nih.gov/pubmed/11451827"
                            "web" => "Medline"
                          ]
                        ]
                      ]
                    ]
                  ]
                ]
              ]
            ]
          ]
        ]
      ]
    ]
  ]
  "idiomaDefecto" => "en"
  "url" => "/15792129/0000004200000006/v1_201305150246/S1579212906601481/v1_201305150246/en/main.assets"
  "Apartado" => null
  "PDF" => "https://static.elsevier.es/multimedia/15792129/0000004200000006/v1_201305150246/S1579212906601481/v1_201305150246/en/main.pdf?idApp=UINPBA00003Z&text.app=https://archbronconeumol.org/"
  "EPUB" => "https://multimedia.elsevier.es/PublicationsMultimediaV1/item/epub/S1579212906601481?idApp=UINPBA00003Z"
]
Share
Journal Information
Vol. 42. Issue 6.
Pages 307-309 (June 2006)
Share
Share
Download PDF
More article options
Vol. 42. Issue 6.
Pages 307-309 (June 2006)
Case Reports
Full text access
Bilateral Hemothorax Secondary to Combined Antiplatelet Therapy With Clopidogrel and Acetylsalicylic Acid
Visits
5777
Manuel Haro Estarriola,
Corresponding author
mip.mharo@htrueta.scs.es

Correspondence: Dr. M. Haro Estarriol. Sección de Neumología (Planta 4.a B). Hospital Universitario de Girona Doctor Josep Trueta. Avda. de Francia, s/n. 17007 Girona. España
, Luis Alberto Álvarez Castilloa, Xavier Baldó Padrób, Anna Palou Rispaua, Matilde Rubio Garayb, Manel Rubio Godaya
a Sección de Neumología, Hospital Universitario de Girona Doctor Josep Trueta, Girona, Spain
b Servicio de Cirugía Torácica, Hospital Universitario de Girona Doctor Josep Trueta, Girona, Spain
This item has received
Article information

Clopidogrel is a platelet aggregation inhibitor that increases the risk of bleeding complications when combined with acetylsalicylic acid. We report a rare case of a 79-year-old male treated with clopidogrel and acetylsalicylic acid after coronary angioplasty and stenting to treat unstable angina. Two months after initiation of therapy, the patient presented with symptomatic bilateral pleural effusion. Examination of both effusions confirmed the diagnosis of spontaneous bilateral hemothorax due to combined antiplatelet therapy. Serious functional sequelae were still present 18 months after diagnosis despite bilateral pleural drainage and respiratory therapy.

Key words:
Clopidogrel
Acetylsalicylic acid
Hemothorax

El clopidogrel es un inhibidor de la agregación plaquetaria que aumenta el riesgo de complicaciones hemorrágicas cuando se combina con el ácido acetilsalicílico. Presentamos un caso excepcional en un varón de 79 años tratado con clopidogrel y ácido acetilsalicílico después de una angioplastia coronaria y la colocación de un stent por una angina inestable. A los 2 meses de tratamiento presentó un derrame pleural bilateral sintomático. El estudio de ambos derrames confirmó el diagnóstico de un hemotórax espontáneo bilateral atribuido a los antiagregantes. El drenaje pleural bilateral y la fisioterapia respiratoria no impidieron la persistencia de importantes secuelas funcionales a los 18 meses del diagnóstico.

Palabras clave:
Clopidogrel
Ácido acetilsalicílico
Hemotórax
Full text is only aviable in PDF
REFERENCES
[1]
MJ Quinn, DJ Fitzgerald.
Ticlopidine and clopidogrel.
Circulation, 100 (1999), pp. 1667-1672
[2]
CAPRIE Steering Committee.
A randomised, blinded, trial of clopidogrel versus aspirin in patients at risk of ischaemic events (CAPRIE).
Lancet, 348 (1996), pp. 1329-1339
[3]
Antithrombotic Trialists' Collaboration.
Collaborative metaanalysis of randomised trials of antiplatelet therapy for prevention of death, myocardial infraction and stroke in high risk patients.
Lancet, 324 (2002), pp. 71-86
[4]
The Clopidogrel in Unstable Angina to Prevent Recurrent Events Trial investigators.
Effects of clopidogrel in addition to aspirin in patients with acute coronary syndromes without ST-segment elevation.
N Engl J Med, 345 (2001), pp. 494-502
[5]
RH Hongo, J Ley, SE Dick.
The effect of clopidogrel in combination with aspirin when given before coronary artery bypass grafting.
J Am Coll Cardiol, 40 (2002), pp. 231-237
[6]
JJ Ibáñez, M Nolla, MA León, MC Martín.
Hemorragia subaracnoidea y clopidrogel.
Med Clin (Barc), 119 (2002), pp. 158-159
[7]
DS Gill, K Ng, KS Ng.
Massive pulmonary haemorrhage complicating the treatment of acute coronary syndrome.
Heart, 90 (2004), pp. 15
[8]
PK Kilaru, MJ Schweiger, HA Kozman, TR Weil.
Diffuse alveolar hemorrhage after clopidogrel use.
J Invasive Cardiol, 13 (2001), pp. 535-537
[9]
RC Jacoby, FD Battistella.
Hemothorax.
Semin Respir Crit Care Med, 22 (2001), pp. 627-630
[10]
V Villena, A López, J Echave, C álvarez, P Martín.
Estudio prospectivo de 1.000 pacientes consecutivos con derrame pleural.
Etiología del derrame y características de los pacientes. Arch Bronconeumol, 38 (2002), pp. 21-26
[11]
P Ausín, A Gómez, FJ Moradiellos.
Hemotórax espontáneo por rotura de aneurisma de arteria pulmonar en la enfermedad de Rendu-Osler.
Arch Bronconeumol, 40 (2004), pp. 602-603
[12]
JM Barreiro, V Leiro, L Piñero.
Hemotórax como forma de presentación de angiosarcoma cardíaco.
Arch Bronconeumol, 41 (2005), pp. 105
[13]
P Ausín, A Gómez, R Pérez, FJ Moradiellos, V Díaz, JL Martín.
Hemotórax espontáneo por carcinoma broncogénico.
Arch Bronconeumol, 41 (2005), pp. 400-401
[14]
FJ Martínez, AG Villanueva, R Pickering, FS Becker, DR Smith.
Spontaneous hemothorax. Report of 6 cases and review of the literature.
Medicine (Baltimore), 71 (1993), pp. 354-368
[15]
MT Margolis, LD Thoen, LJ Mercer, LG Keith.
Hemothorax after Lupron therapy of a patient with pleural endometriosis. A case report and literature review.
Int J Fertil, 41 (1996), pp. 53-55
[16]
MW Quinn, TA Dillard.
Delayed traumatic hemothorax on ticlopidine.
Chest, 116 (1999), pp. 257-260
[17]
H Shennib, M Endo, O Benhameid.
A feasibility study of the safety and efficacy of a combined clopidogrel and aspirin regimen following off-pump coronary artery bypass grafting.
Heart Surg Forum, 6 (2003), pp. 288-291
[18]
S Kalra, MR Bell, CS Rihal.
Alveolar hemorrhage as a complication of treatment with abciximab.
Chest, 120 (2001), pp. 126-131
Copyright © 2006. Sociedad Española de Neumología y Cirugía Torácica (SEPAR)
Archivos de Bronconeumología
Article options
Tools

Are you a health professional able to prescribe or dispense drugs?