Letter to the Editor
Delayed Pulmonary Fibrosis (Usual Interstitial Pneumonia) in a Patient With Previous Uncomplicated H1N1-Associated Pneumonia
Fibrosis pulmonar tardía (neumonía intersticial usual) en un paciente con antecedentes de neumonía asociada a H1N1 no complicada
Guido Baietto, Fabio Davoli
, Davide Turello, Ottavio Rena, Alberto Roncon, Esther Papalia, Fabio Massera, Caterina Casadio
Corresponding author
Thoracic Surgery Unit, University of Eastern Piedmont, Azienda Ospedaliero-Universitaria, Maggiore della Carità, Novara, Italy
Read
6524
Timeswas read the article
1853
Total PDF
4671
Total HTML
Share statistics
array:24 [ "pii" => "S1579212915001159" "issn" => "15792129" "doi" => "10.1016/j.arbr.2015.04.019" "estado" => "S300" "fechaPublicacion" => "2015-07-01" "aid" => "909" "copyright" => "SEPAR" "copyrightAnyo" => "2013" "documento" => "simple-article" "crossmark" => 1 "subdocumento" => "cor" "cita" => "Arch Bronconeumol. 2015;51:363-4" "abierto" => array:3 [ "ES" => false "ES2" => false "LATM" => false ] "gratuito" => false "lecturas" => array:2 [ "total" => 2553 "formatos" => array:3 [ "EPUB" => 128 "HTML" => 1899 "PDF" => 526 ] ] "Traduccion" => array:1 [ "es" => array:19 [ "pii" => "S0300289614000556" "issn" => "03002896" "doi" => "10.1016/j.arbres.2014.01.005" "estado" => "S300" "fechaPublicacion" => "2015-07-01" "aid" => "909" "copyright" => "SEPAR" "documento" => "simple-article" "crossmark" => 1 "subdocumento" => "cor" "cita" => "Arch Bronconeumol. 2015;51:363-4" "abierto" => array:3 [ "ES" => true "ES2" => true "LATM" => true ] "gratuito" => true "lecturas" => array:2 [ "total" => 19190 "formatos" => array:3 [ "EPUB" => 111 "HTML" => 18317 "PDF" => 762 ] ] "es" => array:11 [ "idiomaDefecto" => true "cabecera" => "<span class="elsevierStyleTextfn">Carta al Director</span>" "titulo" => "Fibrosis pulmonar tardía (neumonía intersticial usual) en un paciente con antecedentes de neumonía asociada a H1N1 no complicada" "tienePdf" => "es" "tieneTextoCompleto" => "es" "paginas" => array:1 [ 0 => array:2 [ "paginaInicial" => "363" "paginaFinal" => "364" ] ] "titulosAlternativos" => array:1 [ "en" => array:1 [ "titulo" => "Delayed Pulmonary Fibrosis (Usual Interstitial Pneumonia) in a Patient With Previous Uncomplicated H1N1-Associated Pneumonia" ] ] "contieneTextoCompleto" => array:1 [ "es" => true ] "contienePdf" => array:1 [ "es" => true ] "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" => 484 "Ancho" => 1300 "Tamanyo" => 201816 ] ] "descripcion" => array:1 [ "es" => "<p id="spar0005" class="elsevierStyleSimplePara elsevierViewall">A) TCAR de tórax en la que se observa una borrosidad en vidrio esmerilado y una opacidad reticular periférica que se manifiestan especialmente en las bases pulmonares. B) El examen histopatológico mostró lo siguiente: tabiques alveolares ensanchados con proliferación de neumocitos tipo <span class="elsevierStyleSmallCaps">ii</span> e infiltrado inflamatorio mononuclear con fibrosis intersticial en un patrón en parches <span class="elsevierStyleItalic">(patchwork pattern)</span> que sugería una neumonía intersticial usual (tinción de hematoxilina-eosina, aumentos originales 100×).</p>" ] ] ] "autores" => array:1 [ 0 => array:2 [ "autoresLista" => "Guido Baietto, Fabio Davoli, Davide Turello, Ottavio Rena, Alberto Roncon, Esther Papalia, Fabio Massera, Caterina Casadio" "autores" => array:8 [ 0 => array:2 [ "nombre" => "Guido" "apellidos" => "Baietto" ] 1 => array:2 [ "nombre" => "Fabio" "apellidos" => "Davoli" ] 2 => array:2 [ "nombre" => "Davide" "apellidos" => "Turello" ] 3 => array:2 [ "nombre" => "Ottavio" "apellidos" => "Rena" ] 4 => array:2 [ "nombre" => "Alberto" "apellidos" => "Roncon" ] 5 => array:2 [ "nombre" => "Esther" "apellidos" => "Papalia" ] 6 => array:2 [ "nombre" => "Fabio" "apellidos" => "Massera" ] 7 => array:2 [ "nombre" => "Caterina" "apellidos" => "Casadio" ] ] ] ] ] "idiomaDefecto" => "es" "Traduccion" => array:1 [ "en" => array:9 [ "pii" => "S1579212915001159" "doi" => "10.1016/j.arbr.2015.04.019" "estado" => "S300" "subdocumento" => "" "abierto" => array:3 [ "ES" => false "ES2" => false "LATM" => false ] "gratuito" => false "lecturas" => array:1 [ "total" => 0 ] "idiomaDefecto" => "en" "EPUB" => "https://multimedia.elsevier.es/PublicationsMultimediaV1/item/epub/S1579212915001159?idApp=UINPBA00003Z" ] ] "EPUB" => "https://multimedia.elsevier.es/PublicationsMultimediaV1/item/epub/S0300289614000556?idApp=UINPBA00003Z" "url" => "/03002896/0000005100000007/v2_201506280052/S0300289614000556/v2_201506280052/es/main.assets" ] ] "itemSiguiente" => array:19 [ "pii" => "S1579212915001160" "issn" => "15792129" "doi" => "10.1016/j.arbr.2015.04.020" "estado" => "S300" "fechaPublicacion" => "2015-07-01" "aid" => "919" "copyright" => "SEPAR" "documento" => "simple-article" "crossmark" => 1 "subdocumento" => "cor" "cita" => "Arch Bronconeumol. 2015;51:364-5" "abierto" => array:3 [ "ES" => false "ES2" => false "LATM" => false ] "gratuito" => false "lecturas" => array:2 [ "total" => 2326 "formatos" => array:3 [ "EPUB" => 120 "HTML" => 1700 "PDF" => 506 ] ] "en" => array:11 [ "idiomaDefecto" => true "cabecera" => "<span class="elsevierStyleTextfn">Letter to the Editor</span>" "titulo" => "Occult Alveolar Hemorrhage in a Patient With Bronchopulmonary Kaposi Sarcoma" "tienePdf" => "en" "tieneTextoCompleto" => "en" "paginas" => array:1 [ 0 => array:2 [ "paginaInicial" => "364" "paginaFinal" => "365" ] ] "titulosAlternativos" => array:1 [ "es" => array:1 [ "titulo" => "Hemorragia alveolar oculta en paciente con sarcoma de Kaposi broncopulmonar" ] ] "contieneTextoCompleto" => array:1 [ "en" => true ] "contienePdf" => array:1 [ "en" => true ] "resumenGrafico" => array:2 [ "original" => 0 "multimedia" => array:7 [ "identificador" => "fig0005" "etiqueta" => "Fig. 1" "tipo" => "MULTIMEDIAFIGURA" "mostrarFloat" => true "mostrarDisplay" => false "figura" => array:1 [ 0 => array:4 [ "imagen" => "gr1.jpeg" "Alto" => 545 "Ancho" => 1000 "Tamanyo" => 79613 ] ] "descripcion" => array:1 [ "en" => "<p id="spar0005" class="elsevierStyleSimplePara elsevierViewall">High resolution computed tomography of the chest showing bilateral nodules with irregular margins, ground glass opacities and peribronchial cuffing.</p>" ] ] ] "autores" => array:1 [ 0 => array:2 [ "autoresLista" => "Ingrid Martinez Ramirez, Adan Jose Luquez, Plutarco Garcia Herreros" "autores" => array:3 [ 0 => array:2 [ "nombre" => "Ingrid" "apellidos" => "Martinez Ramirez" ] 1 => array:2 [ "nombre" => "Adan Jose" "apellidos" => "Luquez" ] 2 => array:2 [ "nombre" => "Plutarco" "apellidos" => "Garcia Herreros" ] ] ] ] ] "idiomaDefecto" => "en" "Traduccion" => array:1 [ "es" => array:9 [ "pii" => "S0300289614000659" "doi" => "10.1016/j.arbres.2014.01.014" "estado" => "S300" "subdocumento" => "" "abierto" => array:3 [ "ES" => true "ES2" => true "LATM" => true ] "gratuito" => true "lecturas" => array:1 [ "total" => 0 ] "idiomaDefecto" => "es" "EPUB" => "https://multimedia.elsevier.es/PublicationsMultimediaV1/item/epub/S0300289614000659?idApp=UINPBA00003Z" ] ] "EPUB" => "https://multimedia.elsevier.es/PublicationsMultimediaV1/item/epub/S1579212915001160?idApp=UINPBA00003Z" "url" => "/15792129/0000005100000007/v1_201506250123/S1579212915001160/v1_201506250123/en/main.assets" ] "itemAnterior" => array:19 [ "pii" => "S1579212915001147" "issn" => "15792129" "doi" => "10.1016/j.arbr.2015.04.018" "estado" => "S300" "fechaPublicacion" => "2015-07-01" "aid" => "898" "copyright" => "SEPAR" "documento" => "simple-article" "crossmark" => 1 "subdocumento" => "cor" "cita" => "Arch Bronconeumol. 2015;51:362-3" "abierto" => array:3 [ "ES" => false "ES2" => false "LATM" => false ] "gratuito" => false "lecturas" => array:2 [ "total" => 2296 "formatos" => array:3 [ "EPUB" => 120 "HTML" => 1604 "PDF" => 572 ] ] "en" => array:11 [ "idiomaDefecto" => true "cabecera" => "<span class="elsevierStyleTextfn">Letter to the Editor</span>" "titulo" => "Malignant Solitary Fibrous Tumour of the Pleura: An Uncommon Entity" "tienePdf" => "en" "tieneTextoCompleto" => "en" "paginas" => array:1 [ 0 => array:2 [ "paginaInicial" => "362" "paginaFinal" => "363" ] ] "titulosAlternativos" => array:1 [ "es" => array:1 [ "titulo" => "Tumor fibroso solitario pleural maligno: una rara entidad" ] ] "contieneTextoCompleto" => array:1 [ "en" => true ] "contienePdf" => array:1 [ "en" => true ] "resumenGrafico" => array:2 [ "original" => 0 "multimedia" => array:7 [ "identificador" => "fig0005" "etiqueta" => "Fig. 1" "tipo" => "MULTIMEDIAFIGURA" "mostrarFloat" => true "mostrarDisplay" => false "figura" => array:1 [ 0 => array:4 [ "imagen" => "gr1.jpeg" "Alto" => 640 "Ancho" => 900 "Tamanyo" => 70211 ] ] "descripcion" => array:1 [ "en" => "<p id="spar0005" class="elsevierStyleSimplePara elsevierViewall">Computed axial tomography.</p>" ] ] ] "autores" => array:1 [ 0 => array:2 [ "autoresLista" => "Patricia Cruz Castellanos, Javier de Castro Carpeño" "autores" => array:2 [ 0 => array:2 [ "nombre" => "Patricia" "apellidos" => "Cruz Castellanos" ] 1 => array:2 [ "nombre" => "Javier" "apellidos" => "de Castro Carpeño" ] ] ] ] ] "idiomaDefecto" => "en" "Traduccion" => array:1 [ "es" => array:9 [ "pii" => "S0300289614000283" "doi" => "10.1016/j.arbres.2014.01.001" "estado" => "S300" "subdocumento" => "" "abierto" => array:3 [ "ES" => true "ES2" => true "LATM" => true ] "gratuito" => true "lecturas" => array:1 [ "total" => 0 ] "idiomaDefecto" => "es" "EPUB" => "https://multimedia.elsevier.es/PublicationsMultimediaV1/item/epub/S0300289614000283?idApp=UINPBA00003Z" ] ] "EPUB" => "https://multimedia.elsevier.es/PublicationsMultimediaV1/item/epub/S1579212915001147?idApp=UINPBA00003Z" "url" => "/15792129/0000005100000007/v1_201506250123/S1579212915001147/v1_201506250123/en/main.assets" ] "en" => array:15 [ "idiomaDefecto" => true "cabecera" => "<span class="elsevierStyleTextfn">Letter to the Editor</span>" "titulo" => "Delayed Pulmonary Fibrosis (Usual Interstitial Pneumonia) in a Patient With Previous Uncomplicated H1N1-Associated Pneumonia" "tieneTextoCompleto" => true "saludo" => "To the Editor," "paginas" => array:1 [ 0 => array:2 [ "paginaInicial" => "363" "paginaFinal" => "364" ] ] "autores" => array:1 [ 0 => array:4 [ "autoresLista" => "Guido Baietto, Fabio Davoli, Davide Turello, Ottavio Rena, Alberto Roncon, Esther Papalia, Fabio Massera, Caterina Casadio" "autores" => array:8 [ 0 => array:2 [ "nombre" => "Guido" "apellidos" => "Baietto" ] 1 => array:4 [ "nombre" => "Fabio" "apellidos" => "Davoli" "email" => array:1 [ 0 => "fab_78_16l@hotmail.com" ] "referencia" => array:1 [ 0 => array:2 [ "etiqueta" => "<span class="elsevierStyleSup">*</span>" "identificador" => "cor0005" ] ] ] 2 => array:2 [ "nombre" => "Davide" "apellidos" => "Turello" ] 3 => array:2 [ "nombre" => "Ottavio" "apellidos" => "Rena" ] 4 => array:2 [ "nombre" => "Alberto" "apellidos" => "Roncon" ] 5 => array:2 [ "nombre" => "Esther" "apellidos" => "Papalia" ] 6 => array:2 [ "nombre" => "Fabio" "apellidos" => "Massera" ] 7 => array:2 [ "nombre" => "Caterina" "apellidos" => "Casadio" ] ] "afiliaciones" => array:1 [ 0 => array:2 [ "entidad" => "Thoracic Surgery Unit, University of Eastern Piedmont, Azienda Ospedaliero-Universitaria, Maggiore della Carità, Novara, Italy" "identificador" => "aff0005" ] ] "correspondencia" => array:1 [ 0 => array:3 [ "identificador" => "cor0005" "etiqueta" => "⁎" "correspondencia" => "Corresponding author." ] ] ] ] "titulosAlternativos" => array:1 [ "es" => array:1 [ "titulo" => "Fibrosis pulmonar tardía (neumonía intersticial usual) en un paciente con antecedentes de neumonía asociada a H1N1 no complicada" ] ] "resumenGrafico" => array:2 [ "original" => 0 "multimedia" => array:7 [ "identificador" => "fig0005" "etiqueta" => "Fig. 1" "tipo" => "MULTIMEDIAFIGURA" "mostrarFloat" => true "mostrarDisplay" => false "figura" => array:1 [ 0 => array:4 [ "imagen" => "gr1.jpeg" "Alto" => 484 "Ancho" => 1300 "Tamanyo" => 214329 ] ] "descripcion" => array:1 [ "en" => "<p id="spar0005" class="elsevierStyleSimplePara elsevierViewall">(A) Chest high-resolution computed tomography showing ground glass and peripheral reticular opacities, particularly evident in the lung bases. (B) Histopathological examination revealed the following: widened alveolar septa with type II pneumocyte proliferation and inflammatory mononuclear infiltrate with interstitial fibrosis in a patchwork pattern, suggesting usual interstitial pneumonia (hematoxylin-eosin staining, original magnification 100×).</p>" ] ] ] "textoCompleto" => "<span class="elsevierStyleSections"><p id="par0005" class="elsevierStylePara elsevierViewall">In February 2011, a 53-year-old man was admitted to our hospital for fever, non-productive cough and dyspnea on effort; he did not report any history of workplace exposure during the medical examination.</p><p id="par0010" class="elsevierStylePara elsevierViewall">Computed tomography (CT) of the chest showed bilateral pulmonary consolidations, mainly involving the lower lobes.</p><p id="par0015" class="elsevierStylePara elsevierViewall">No leukocytosis was seen on the blood tests, and the differential leukocyte count was 72.7% neutrophils and 18.5% lymphocytes. Serum biochemistry results were normal. Tests for anti-neutrophil cytoplasmic antibodies (ANCA), antinuclear antibodies (ANA), anti-DNA antibodies and extractable nuclear antigens (ENA) were negative.</p><p id="par0020" class="elsevierStylePara elsevierViewall">Arterial blood gases (ABG) showed moderate hypoxemia, with partial oxygen pressure (PO<span class="elsevierStyleInf">2</span>) 52<span class="elsevierStyleHsp" style=""></span>mmHg, PCO<span class="elsevierStyleInf">2</span> 34<span class="elsevierStyleHsp" style=""></span>mmHg, and pH 7.48; arterial oxygen saturation (SaO<span class="elsevierStyleInf">2</span>) was 88%.</p><p id="par0025" class="elsevierStylePara elsevierViewall">Pharyngeal swab analysis was positive for H1N1.</p><p id="par0030" class="elsevierStylePara elsevierViewall">The patient was referred to the infectious diseases unit, where he received combined treatment with prednisone 25<span class="elsevierStyleHsp" style=""></span>mg, orally, twice a day for 10 days, cefotaxime 1<span class="elsevierStyleHsp" style=""></span>g, intravenously, twice a day for 10 days, inhaled zanamivir (2<span class="elsevierStyleHsp" style=""></span>mg<span class="elsevierStyleHsp" style=""></span>×<span class="elsevierStyleHsp" style=""></span>5<span class="elsevierStyleHsp" style=""></span>mg) twice a day for 5 days and oseltamir, 1 75<span class="elsevierStyleHsp" style=""></span>mg capsule twice a day for 5 days. The patient's clinical situation improved rapidly, as reflected in radiological and ABG results. Twenty days later, he was discharged in good condition.</p><p id="par0035" class="elsevierStylePara elsevierViewall">A chest CT was performed before discharge, showing good recovery of lung function, and ABG results were normal (pH=7.41; PCO<span class="elsevierStyleInf">2</span>=37<span class="elsevierStyleHsp" style=""></span>mmHg; PO<span class="elsevierStyleInf">2</span>=85<span class="elsevierStyleHsp" style=""></span>mmHg and SaO<span class="elsevierStyleInf">2</span>=96%).</p><p id="par0040" class="elsevierStylePara elsevierViewall">The patient was then referred for respiratory follow-up, including high-resolution computed tomography (HRCT) scans, ABG analysis and lung function testing with determination of the diffusing capacity of the lungs for carbon monoxide (DLCO).</p><p id="par0045" class="elsevierStylePara elsevierViewall">At the 1, 3 and 6-month follow-up visits, the patient was asymptomatic; serial chest HRCTs showed slight basal consolidation, less than 3<span class="elsevierStyleHsp" style=""></span>cm in diameter, in the form of reticular and ground glass opacities.</p><p id="par0050" class="elsevierStylePara elsevierViewall">During this time, the radiological signs did not alter either in shape or in size. Lung function test results were normal: FVC=86.6%; FEV1=96%; FEV1/FVC: 88.47; DLCO: 78% and SpO<span class="elsevierStyleInf">2</span>: 96%.</p><p id="par0055" class="elsevierStylePara elsevierViewall">In May 2012, the patient became symptomatic again, with non-productive cough and dyspnea on effort. He returned to the clinic with marked reduction in lung function parameters: FVC=66.7%; FEV1=76.2%; FEV1/FVC=90.63, SpO<span class="elsevierStyleInf">2</span>=91%; DLCO values were also severely reduced (55% compared to 78%).</p><p id="par0060" class="elsevierStylePara elsevierViewall">Another chest HRCT was then performed, revealing ground glass and peripheral reticular opacity, particularly in the lung bases (<a class="elsevierStyleCrossRef" href="#fig0005">Fig. 1</a>A).</p><elsevierMultimedia ident="fig0005"></elsevierMultimedia><p id="par0065" class="elsevierStylePara elsevierViewall">Blood and serum test results were normal. A flexible fiberoptic bronchoscopy was performed, and a transbronchial biopsy was obtained, the results of which were indecisive—only inflammatory lymphocyte infiltration and alveolar septal fibrosclerosis were found on histopathology examination. Bronchoalveolar lavage (BAL) results were negative.</p><p id="par0070" class="elsevierStylePara elsevierViewall">A surgical lung biopsy was performed using video-assisted thoracoscopic surgery (VATS) under general anesthesia with one-lung ventilation, and 3-port incision in the right side (one sample per lobe).</p><p id="par0075" class="elsevierStylePara elsevierViewall">Histopathological analysis revealed widened alveolar septa with type II pneumocyte proliferation and mononuclear inflammatory infiltrate with interstitial fibrosis in patchwork pattern, suggesting usual interstitial pneumonia (<a class="elsevierStyleCrossRef" href="#fig0005">Fig. 1</a>B). After an incident-free post-operative period, the patient was referred to the pulmonology unit for appropriate medical treatment.</p><p id="par0080" class="elsevierStylePara elsevierViewall">Although the etiology of usual interstitial pneumonia (UIP) is unknown, the following risk factors have been proposed: acute respiratory distress syndrome (ARDS), environmental exposure to metal dust, smoking habit, connective tissue disorders, drug toxicity, chronic viral infections, such as Epstein–Barr virus, cytomegalovirus, hepatitis C virus, human herpesvirus (HHV)-7 and HHV-8.<a class="elsevierStyleCrossRef" href="#bib0035"><span class="elsevierStyleSup">1</span></a></p><p id="par0085" class="elsevierStylePara elsevierViewall">Ground glass opacity on chest imaging studies and reduced DLCO have been reported in H1N1 pneumonia in a study with 3 months’ follow-up.<a class="elsevierStyleCrossRefs" href="#bib0040"><span class="elsevierStyleSup">2,3</span></a> We report a very uncommon case of late-onset UIP after uncomplicated H1N1 pneumonia in a 53-year-old man, detected in HRCT obtained one year after the disease onset.</p><p id="par0090" class="elsevierStylePara elsevierViewall">These results, along with the histopathology examination, were consistent with the development of pulmonary fibrosis. Pulmonary fibrosis may occur after ARDS or ventilator-associated pneumonia.<a class="elsevierStyleCrossRefs" href="#bib0050"><span class="elsevierStyleSup">4,5</span></a></p><p id="par0095" class="elsevierStylePara elsevierViewall">In our patient, radiological signs of fibrosis were confirmed by histopathological examination of surgical biopsy specimens obtained by standard VATS.<a class="elsevierStyleCrossRef" href="#bib0060"><span class="elsevierStyleSup">6</span></a></p><p id="par0100" class="elsevierStylePara elsevierViewall">By presenting this case, we wish to draw attention to long-term sequelae in a patient with no prior history of ARDS and who did not require mechanical ventilation. Symptomatic pulmonary fibrosis with a UIP pattern on HRCT and histopathological signs were detected one year after an influenza-like infection, but otherwise, the patient was a healthy adult who did not present any of the comorbidities usually associated with influenza.</p><p id="par0105" class="elsevierStylePara elsevierViewall">Several cases of ARDS subsequent to H1N1 have been described in the literature,<a class="elsevierStyleCrossRefs" href="#bib0050"><span class="elsevierStyleSup">4–6</span></a> but this is the first report of a correlation between H1N1 and UIP, and we believe this to be the unique feature of our case.</p></span>" "pdfFichero" => "main.pdf" "tienePdf" => true "NotaPie" => array:1 [ 0 => array:2 [ "etiqueta" => "☆" "nota" => "<p class="elsevierStyleNotepara" id="npar0005">Please cite this article as: Baietto G, Davoli F, Turello D, Rena O, Roncon A, Papalia E, et al. Fibrosis pulmonar tardía (neumonía intersticial usual) en un paciente con antecedentes de neumonía asociada a H1N1 no complicada. Arch Bronconeumol. 2015;51:363–364.</p>" ] ] "multimedia" => array:1 [ 0 => array:7 [ "identificador" => "fig0005" "etiqueta" => "Fig. 1" "tipo" => "MULTIMEDIAFIGURA" "mostrarFloat" => true "mostrarDisplay" => false "figura" => array:1 [ 0 => array:4 [ "imagen" => "gr1.jpeg" "Alto" => 484 "Ancho" => 1300 "Tamanyo" => 214329 ] ] "descripcion" => array:1 [ "en" => "<p id="spar0005" class="elsevierStyleSimplePara elsevierViewall">(A) Chest high-resolution computed tomography showing ground glass and peripheral reticular opacities, particularly evident in the lung bases. (B) Histopathological examination revealed the following: widened alveolar septa with type II pneumocyte proliferation and inflammatory mononuclear infiltrate with interstitial fibrosis in a patchwork pattern, suggesting usual interstitial pneumonia (hematoxylin-eosin staining, original magnification 100×).</p>" ] ] ] "bibliografia" => array:2 [ "titulo" => "References" "seccion" => array:1 [ 0 => array:2 [ "identificador" => "bibs0005" "bibliografiaReferencia" => array:6 [ 0 => array:3 [ "identificador" => "bib0035" "etiqueta" => "1" "referencia" => array:1 [ 0 => array:2 [ "contribucion" => array:1 [ 0 => array:2 [ "titulo" => "An official ATS/ERS/JRS/ALAT statement: idiopathic pulmonary fibrosis: evidence-based guidelines for diagnosis and management" "autores" => array:1 [ 0 => array:3 [ "colaboracion" => "ATS/ERS/JRS/ALAT Committee on Idiopathic Pulmonary Fibrosis" "etal" => true "autores" => array:6 [ 0 => "G. Raghu" 1 => "H.R. Collard" 2 => "J.J. Egan" 3 => "F.J. Martínez" 4 => "J. Behr" 5 => "K.K. Brown" ] ] ] ] ] "host" => array:1 [ 0 => array:2 [ "doi" => "10.1164/rccm.2009-040GL" "Revista" => array:6 [ "tituloSerie" => "Am J Respir Crit Care Med" "fecha" => "2011" "volumen" => "183" "paginaInicial" => "788" "paginaFinal" => "824" "link" => array:1 [ 0 => array:2 [ "url" => "https://www.ncbi.nlm.nih.gov/pubmed/21471066" "web" => "Medline" ] ] ] ] ] ] ] ] 1 => array:3 [ "identificador" => "bib0040" "etiqueta" => "2" "referencia" => array:1 [ 0 => array:2 [ "contribucion" => array:1 [ 0 => array:2 [ "titulo" => "Pulmonary pathologic findings of fatal 2009 pandemic influenza A/H1N1 viral infections" "autores" => array:1 [ 0 => array:2 [ "etal" => true "autores" => array:6 [ 0 => "J.R. Gill" 1 => "Z.M. Sheng" 2 => "S.F. Ely" 3 => "D.G. Guinee" 4 => "M.B. Beasley" 5 => "J. Suh" ] ] ] ] ] "host" => array:1 [ 0 => array:2 [ "doi" => "10.1043/1543-2165-134.2.235" "Revista" => array:7 [ "tituloSerie" => "Arch Pathol Lab Med" "fecha" => "2010" "volumen" => "134" "paginaInicial" => "235" "paginaFinal" => "243" "link" => array:1 [ 0 => array:2 [ "url" => "https://www.ncbi.nlm.nih.gov/pubmed/20121613" "web" => "Medline" ] ] "itemHostRev" => array:3 [ "pii" => "S0022534708003157" "estado" => "S300" "issn" => "00225347" ] ] ] ] ] ] ] 2 => array:3 [ "identificador" => "bib0045" "etiqueta" => "3" "referencia" => array:1 [ 0 => array:2 [ "contribucion" => array:1 [ 0 => array:2 [ "titulo" => "Pulmonary sequelae in a patient recovered from swine flu" "autores" => array:1 [ 0 => array:2 [ "etal" => false "autores" => array:3 [ 0 => "V. Singh" 1 => "B.B. Sharma" 2 => "V. Patel" ] ] ] ] ] "host" => array:1 [ 0 => array:2 [ "doi" => "10.4103/0970-2113.99118" "Revista" => array:7 [ "tituloSerie" => "Lung India" "fecha" => "2012" "volumen" => "29" "paginaInicial" => "277" "paginaFinal" => "279" "link" => array:1 [ 0 => array:2 [ "url" => "https://www.ncbi.nlm.nih.gov/pubmed/22919170" "web" => "Medline" ] ] "itemHostRev" => array:3 [ "pii" => "S0022534713043759" "estado" => "S300" "issn" => "00225347" ] ] ] ] ] ] ] 3 => array:3 [ "identificador" => "bib0050" "etiqueta" => "4" "referencia" => array:1 [ 0 => array:2 [ "contribucion" => array:1 [ 0 => array:2 [ "titulo" => "Clinical features of pneumonia caused by influenza a (H1N1) virus in Beijing, China" "autores" => array:1 [ 0 => array:2 [ "etal" => true "autores" => array:6 [ 0 => "L. Bai" 1 => "L. Gu" 2 => "B. Cao" 3 => "X.L. Zhai" 4 => "M. Lu" 5 => "Y. Lu" ] ] ] ] ] "host" => array:1 [ 0 => array:2 [ "doi" => "10.1378/chest.10-1036" "Revista" => array:7 [ "tituloSerie" => "Chest" "fecha" => "2011" "volumen" => "139" "paginaInicial" => "1156" "paginaFinal" => "1164" "link" => array:1 [ 0 => array:2 [ "url" => "https://www.ncbi.nlm.nih.gov/pubmed/20864615" "web" => "Medline" ] ] "itemHostRev" => array:3 [ "pii" => "S0090429512008692" "estado" => "S300" "issn" => "00904295" ] ] ] ] ] ] ] 4 => array:3 [ "identificador" => "bib0055" "etiqueta" => "5" "referencia" => array:1 [ 0 => array:2 [ "contribucion" => array:1 [ 0 => array:2 [ "titulo" => "One-year outcomes in survivors of the acute respiratory distress syndrome" "autores" => array:1 [ 0 => array:2 [ "etal" => true "autores" => array:6 [ 0 => "M.S. Herridge" 1 => "A.M. Cheung" 2 => "C.M. Tansey" 3 => "A. Matte-Martyn" 4 => "N. Díaz-Granados" 5 => "F. Al-Saidi" ] ] ] ] ] "host" => array:1 [ 0 => array:2 [ "doi" => "10.1056/NEJMoa022450" "Revista" => array:6 [ "tituloSerie" => "N Engl J Med" "fecha" => "2003" "volumen" => "348" "paginaInicial" => "683" "paginaFinal" => "693" "link" => array:1 [ 0 => array:2 [ "url" => "https://www.ncbi.nlm.nih.gov/pubmed/12594312" "web" => "Medline" ] ] ] ] ] ] ] ] 5 => array:3 [ "identificador" => "bib0060" "etiqueta" => "6" "referencia" => array:1 [ 0 => array:2 [ "contribucion" => array:1 [ 0 => array:2 [ "titulo" => "Parenchymal injury, fibrosis, and pneumatocele in an H1N1-positive patient" "autores" => array:1 [ 0 => array:2 [ "etal" => false "autores" => array:5 [ 0 => "J. Morales-Blanhir" 1 => "L.M. Argote-Greene" 2 => "L.A. Martín-Del-Campo" 3 => "I. Carranza-Martínez" 4 => "P. Santillan-Doherty" ] ] ] ] ] "host" => array:1 [ 0 => array:1 [ "Revista" => array:4 [ "tituloSerie" => "Chest" "fecha" => "2010" "volumen" => "138" "paginaInicial" => "38a" ] ] ] ] ] ] ] ] ] ] ] "idiomaDefecto" => "en" "url" => "/15792129/0000005100000007/v1_201506250123/S1579212915001159/v1_201506250123/en/main.assets" "Apartado" => array:4 [ "identificador" => "14576" "tipo" => "SECCION" "es" => array:2 [ "titulo" => "Letters to the editor" "idiomaDefecto" => true ] "idiomaDefecto" => "es" ] "PDF" => "https://static.elsevier.es/multimedia/15792129/0000005100000007/v1_201506250123/S1579212915001159/v1_201506250123/en/main.pdf?idApp=UINPBA00003Z&text.app=https://archbronconeumol.org/" "EPUB" => "https://multimedia.elsevier.es/PublicationsMultimediaV1/item/epub/S1579212915001159?idApp=UINPBA00003Z" ]
| Year/Month | Html | Total | |
|---|---|---|---|
| 2024 November | 2 | 0 | 2 |
| 2024 October | 49 | 17 | 66 |
| 2024 September | 61 | 13 | 74 |
| 2024 August | 71 | 42 | 113 |
| 2024 July | 48 | 26 | 74 |
| 2024 June | 56 | 26 | 82 |
| 2024 May | 67 | 32 | 99 |
| 2024 April | 41 | 27 | 68 |
| 2024 March | 54 | 18 | 72 |
| 2024 February | 39 | 17 | 56 |
| 2023 March | 5 | 7 | 12 |
| 2023 February | 50 | 20 | 70 |
| 2023 January | 60 | 33 | 93 |
| 2022 December | 52 | 29 | 81 |
| 2022 November | 62 | 26 | 88 |
| 2022 October | 59 | 31 | 90 |
| 2022 September | 51 | 28 | 79 |
| 2022 August | 43 | 36 | 79 |
| 2022 July | 39 | 41 | 80 |
| 2022 June | 41 | 37 | 78 |
| 2022 May | 49 | 48 | 97 |
| 2022 April | 60 | 32 | 92 |
| 2022 March | 58 | 55 | 113 |
| 2022 February | 73 | 60 | 133 |
| 2022 January | 67 | 40 | 107 |
| 2021 December | 53 | 38 | 91 |
| 2021 November | 79 | 39 | 118 |
| 2021 October | 53 | 43 | 96 |
| 2021 September | 45 | 49 | 94 |
| 2021 August | 64 | 23 | 87 |
| 2021 July | 35 | 26 | 61 |
| 2021 June | 78 | 34 | 112 |
| 2021 May | 54 | 26 | 80 |
| 2021 April | 138 | 75 | 213 |
| 2021 March | 77 | 21 | 98 |
| 2021 February | 50 | 14 | 64 |
| 2021 January | 62 | 7 | 69 |
| 2020 December | 72 | 18 | 90 |
| 2020 November | 73 | 10 | 83 |
| 2020 October | 65 | 16 | 81 |
| 2020 September | 41 | 11 | 52 |
| 2020 August | 66 | 22 | 88 |
| 2020 July | 61 | 25 | 86 |
| 2020 June | 60 | 14 | 74 |
| 2020 May | 89 | 20 | 109 |
| 2020 April | 98 | 36 | 134 |
| 2020 March | 84 | 19 | 103 |
| 2020 February | 46 | 11 | 57 |
| 2020 January | 52 | 27 | 79 |
| 2019 December | 55 | 21 | 76 |
| 2019 November | 43 | 21 | 64 |
| 2019 October | 63 | 10 | 73 |
| 2019 September | 49 | 12 | 61 |
| 2019 August | 34 | 14 | 48 |
| 2019 July | 36 | 15 | 51 |
| 2019 June | 39 | 7 | 46 |
| 2019 May | 54 | 24 | 78 |
| 2019 April | 49 | 24 | 73 |
| 2019 March | 56 | 17 | 73 |
| 2019 February | 44 | 22 | 66 |
| 2019 January | 51 | 10 | 61 |
| 2018 December | 445 | 21 | 466 |
| 2018 November | 55 | 22 | 77 |
| 2018 October | 50 | 22 | 72 |
| 2018 September | 22 | 15 | 37 |
| 2018 May | 6 | 0 | 6 |
| 2018 April | 37 | 7 | 44 |
| 2018 March | 22 | 3 | 25 |
| 2018 February | 25 | 5 | 30 |
| 2018 January | 22 | 6 | 28 |
| 2017 December | 26 | 5 | 31 |
| 2017 November | 24 | 6 | 30 |
| 2017 October | 26 | 7 | 33 |
| 2017 September | 22 | 14 | 36 |
| 2017 August | 19 | 10 | 29 |
| 2017 July | 16 | 11 | 27 |
| 2017 June | 39 | 23 | 62 |
| 2017 May | 40 | 5 | 45 |
| 2017 April | 29 | 10 | 39 |
| 2017 March | 25 | 4 | 29 |
| 2017 February | 16 | 6 | 22 |
| 2017 January | 10 | 9 | 19 |
| 2016 December | 39 | 5 | 44 |
| 2016 November | 46 | 11 | 57 |
| 2016 October | 41 | 13 | 54 |
| 2016 September | 36 | 19 | 55 |
| 2016 August | 46 | 15 | 61 |
| 2016 July | 31 | 9 | 40 |
| 2016 March | 2 | 0 | 2 |
| 2016 February | 1 | 0 | 1 |
| 2015 December | 4 | 0 | 4 |
| 2015 November | 1 | 5 | 6 |
| 2015 October | 23 | 3 | 26 |
Show all
