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Bronquitis plástica en un paciente con silicosis
Plastic bronchitis in a patient with silicosis
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"identificador" => "aff0005" ] 1 => array:2 [ "etiqueta" => "<span class="elsevierStyleSup">b</span>" "identificador" => "aff0010" ] 2 => array:2 [ "etiqueta" => "<span class="elsevierStyleSup">*</span>" "identificador" => "cor0005" ] ] ] 1 => array:3 [ "nombre" => "Victoria" "apellidos" => "Arnalich Montiel" "referencia" => array:2 [ 0 => array:2 [ "etiqueta" => "<span class="elsevierStyleSup">a</span>" "identificador" => "aff0005" ] 1 => array:2 [ "etiqueta" => "<span class="elsevierStyleSup">b</span>" "identificador" => "aff0010" ] ] ] 2 => array:3 [ "nombre" => "José Luis" "apellidos" => "Guerra Vales" "referencia" => array:2 [ 0 => array:2 [ "etiqueta" => "<span class="elsevierStyleSup">a</span>" "identificador" => "aff0005" ] 1 => array:2 [ "etiqueta" => "<span class="elsevierStyleSup">b</span>" "identificador" => "aff0010" ] ] ] ] "afiliaciones" => array:2 [ 0 => array:3 [ "entidad" => "Servicio de Neumoloxía, Hospital Alvaro Cunqueiro, EOXI, Vigo, Pontevedra, España" "etiqueta" => "a" "identificador" => "aff0005" ] 1 => array:3 [ "entidad" => "IRIDIS Group (Investigation in Rheumatology and Immuno-Mediated Diseases) del Instituto de Investigación Biomédica de Vigo, Ourense y Pontevedra, Vigo, Pontevedra, España" "etiqueta" => "b" "identificador" => "aff0010" ] ] "correspondencia" => array:1 [ 0 => array:3 [ "identificador" => "cor0005" "etiqueta" => "⁎" "correspondencia" => "Autor para correspondencia." ] ] ] ] "titulosAlternativos" => array:1 [ "en" => array:1 [ "titulo" => "Plastic bronchitis in a patient with silicosis" ] ] "resumenGrafico" => array:2 [ "original" => 0 "multimedia" => array:7 [ "identificador" => "fig0005" "etiqueta" => "Figura 1" "tipo" => "MULTIMEDIAFIGURA" "mostrarFloat" => true "mostrarDisplay" => false "figura" => array:1 [ 0 => array:4 [ "imagen" => "gr1.jpeg" "Alto" => 1401 "Ancho" => 956 "Tamanyo" => 160163 ] ] "descripcion" => array:1 [ "es" => "<p id="spar0005" class="elsevierStyleSimplePara elsevierViewall">a) Patrón intersticial con conglomerados bilaterales; b) Molde bronquial expectorado.</p>" ] ] ] "textoCompleto" => "<span class="elsevierStyleSections"><p id="par0005" class="elsevierStylePara elsevierViewall">Varón de 49 años con silicosis complicada y antecedentes de tuberculosis pulmonar. Presenta limitación obstructiva al flujo aéreo sin tabaquismo. Consulta por episodios de disnea intensa coincidiendo con expectoración de secreciones espesas sanguinolentas con apariencia de árbol bronquial (<a class="elsevierStyleCrossRef" href="#fig0005">fig. 1</a>), que se repiten varios días a la semana. La fibrobroncoscopia no mostró hallazgos relevantes y el estudio anatomopatológico del molde bronquial objetivó material mucoide y fibrinoinflamatorio con abundantes histiocitos.</p><elsevierMultimedia ident="fig0005"></elsevierMultimedia><p id="par0010" class="elsevierStylePara elsevierViewall">La bronquitis plástica (BP) es una rara enfermedad pulmonar caracterizada por la formación y expectoración de moldes bronquiales que provocan obstrucción de la luz bronquial<a class="elsevierStyleCrossRef" href="#bib0015"><span class="elsevierStyleSup">1</span></a>. Se describe como complicación de anomalías linfáticas primarias y en pacientes con enfermedad cardiaca congénita (después de la operación de Fontan), infecciones respiratorias, fibrosis quística, EPOC y aspergilosis broncopulmonar alérgica<a class="elsevierStyleCrossRef" href="#bib0015"><span class="elsevierStyleSup">1</span></a>. Presentamos el caso de una BP asociada a silicosis. El tratamiento es controvertido, las opciones terapéuticas se basan en casos aislados, destacando la dornasa alfa, macrólidos a baja dosis, suero salino hipertónico y acetilcisteína nebulizados. Existen casos de respuesta a la inhalación de fibrinolíticos y heparina nebulizada<a class="elsevierStyleCrossRefs" href="#bib0015"><span class="elsevierStyleSup">1,2</span></a>. En el caso que presentamos los episodios de expulsión de tapones han disminuido notablemente con prednisona (15<span class="elsevierStyleHsp" style=""></span>mg/día) y heparina sódica nebulizada (5.000<span class="elsevierStyleHsp" style=""></span>UI/12<span class="elsevierStyleHsp" style=""></span>h).</p></span>" "pdfFichero" => "main.pdf" "tienePdf" => true "multimedia" => array:1 [ 0 => array:7 [ "identificador" => "fig0005" "etiqueta" => "Figura 1" "tipo" => "MULTIMEDIAFIGURA" "mostrarFloat" => true "mostrarDisplay" => false "figura" => array:1 [ 0 => array:4 [ "imagen" => "gr1.jpeg" "Alto" => 1401 "Ancho" => 956 "Tamanyo" => 160163 ] ] "descripcion" => array:1 [ "es" => "<p id="spar0005" class="elsevierStyleSimplePara elsevierViewall">a) Patrón intersticial con conglomerados bilaterales; b) Molde bronquial expectorado.</p>" ] ] ] "bibliografia" => array:2 [ "titulo" => "Bibliografía" "seccion" => array:1 [ 0 => array:2 [ "identificador" => "bibs0005" "bibliografiaReferencia" => array:2 [ 0 => array:3 [ "identificador" => "bib0015" "etiqueta" => "1" "referencia" => array:1 [ 0 => array:2 [ "contribucion" => array:1 [ 0 => array:2 [ "titulo" => "Plastic bronchitis" "autores" => array:1 [ 0 => array:2 [ "etal" => false "autores" => array:1 [ 0 => "B.K. Rubin" ] ] ] ] ] "host" => array:1 [ 0 => array:2 [ "doi" => "10.1016/j.ccm.2016.04.003" "Revista" => array:6 [ "tituloSerie" => "Clin Chest Med" "fecha" => "2016" "volumen" => "37" "paginaInicial" => "405" "paginaFinal" => "408" "link" => array:1 [ 0 => array:2 [ "url" => "https://www.ncbi.nlm.nih.gov/pubmed/27514587" "web" => "Medline" ] ] ] ] ] ] ] ] 1 => array:3 [ "identificador" => "bib0020" "etiqueta" => "2" "referencia" => array:1 [ 0 => array:2 [ "contribucion" => array:1 [ 0 => array:2 [ "titulo" => "Plastic bronchitis: A management challenge" "autores" => array:1 [ 0 => array:2 [ "etal" => false "autores" => array:3 [ 0 => "M.H. Eberlein" 1 => "M.B. Drummond" 2 => "E.F. Haponik" ] ] ] ] ] "host" => array:1 [ 0 => array:2 [ "doi" => "10.1097/MAJ.0b013e318068b60e" "Revista" => array:6 [ "tituloSerie" => "Am J Med Sci" "fecha" => "2008" "volumen" => "335" "paginaInicial" => "163" "paginaFinal" => "169" "link" => array:1 [ 0 => array:2 [ "url" => "https://www.ncbi.nlm.nih.gov/pubmed/18277130" "web" => "Medline" ] ] ] ] ] ] ] ] ] ] ] ] ] "idiomaDefecto" => "es" "url" => "/03002896/0000005300000009/v2_201708291404/S030028961730056X/v2_201708291404/es/main.assets" "Apartado" => array:4 [ "identificador" => "45361" "tipo" => "SECCION" "es" => array:2 [ "titulo" => "Imagen clínica" "idiomaDefecto" => true ] "idiomaDefecto" => "es" ] "PDF" => "https://static.elsevier.es/multimedia/03002896/0000005300000009/v2_201708291404/S030028961730056X/v2_201708291404/es/main.pdf?idApp=UINPBA00003Z&text.app=https://archbronconeumol.org/" "EPUB" => "https://multimedia.elsevier.es/PublicationsMultimediaV1/item/epub/S030028961730056X?idApp=UINPBA00003Z" ]
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