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"apellidos" => "Lima Álvarez" "email" => array:2 [ 0 => "jorgelial@hotmail.com" 1 => "jorge.lima.sspa@juntadeandalucia.es" ] "referencia" => array:2 [ 0 => array:2 [ "etiqueta" => "<span class="elsevierStyleSup">a</span>" "identificador" => "aff0005" ] 1 => array:2 [ "etiqueta" => "<span class="elsevierStyleSup">*</span>" "identificador" => "cor0005" ] ] ] 1 => array:3 [ "nombre" => "Nicolás" "apellidos" => "Peña Griñán" "referencia" => array:1 [ 0 => array:2 [ "etiqueta" => "<span class="elsevierStyleSup">a</span>" "identificador" => "aff0005" ] ] ] 2 => array:3 [ "nombre" => "Isabel" "apellidos" => "Simón Pilo" "referencia" => array:1 [ 0 => array:2 [ "etiqueta" => "<span class="elsevierStyleSup">b</span>" "identificador" => "aff0010" ] ] ] ] "afiliaciones" => array:2 [ 0 => array:3 [ "entidad" => "Unidad de Neumología, Hospital Universitario Virgen de Valme, Sevilla, Spain" "etiqueta" => "a" "identificador" => "aff0005" ] 1 => array:3 [ "entidad" => "Unidad de Hematología, Hospital Universitario Virgen de Valme, Sevilla, Spain" "etiqueta" => "b" "identificador" => "aff0010" ] ] "correspondencia" => array:1 [ 0 => array:3 [ "identificador" => "cor0005" "etiqueta" => "⁎" "correspondencia" => "Corresponding author." ] ] ] ] "titulosAlternativos" => array:1 [ "es" => array:1 [ "titulo" => "Derrame pleural eosinofílico secundario a síndrome hipereosinofílico idiopático" ] ] "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" => 570 "Ancho" => 953 "Tamanyo" => 66698 ] ] "descripcion" => array:1 [ "en" => "<p id="spar0005" class="elsevierStyleSimplePara elsevierViewall">Chest computed tomography showing bilateral pleural effusion with lack of pulmonary involvement.</p>" ] ] ] "textoCompleto" => "<span class="elsevierStyleSections"><p id="par0005" class="elsevierStylePara elsevierViewall">Eosinophilic pleural effusion (EPE) is pleural effusion (PE) in which eosinophils account for more than 10% of pleural fluid (PF) cellularity. In published series on PE, about 7.5% of the population show EPE.<a class="elsevierStyleCrossRefs" href="#bib0030"><span class="elsevierStyleSup">1,2</span></a> The most common overall cause of EPE is air or blood in the pleural space and the most common known etiology is malignant disease. Idiopathic hypereosinophilic syndrome (IHES) is a heterogeneous group of disorders consisting of hypereosinophilia, defined as an absolute eosinophil count >1.5×10<span class="elsevierStyleSup">9</span>/l or >1500<span class="elsevierStyleHsp" style=""></span>cells/μl in 2 consecutive samples obtained 1 month apart, combined with eosinophil-induced organ damage, when other causes of hypereosinophilia have been excluded.</p><p id="par0010" class="elsevierStylePara elsevierViewall">We report the case of a 25-year-old man with bilateral PE (<a class="elsevierStyleCrossRef" href="#fig0005">Fig. 1</a>). Complete blood count showed eosinophil concentrations of 3500/mm<span class="elsevierStyleSup">3</span>, representing 26% of total white blood cells. He had shown similar results on previous tests. PF initially had a turbid appearance, with characteristics of exudate, glucose levels of 64<span class="elsevierStyleHsp" style=""></span>mg/dl and adenosine deaminase levels of 27.7<span class="elsevierStyleHsp" style=""></span>U/l. PF cytology showed no malignant cells and acutely predominant inflammatory cells, with abundant eosinophils (50%–60% of total cell count). PF culture was negative for bacteria, mycobacteria and fungi. Echocardiography showed neither pericardial effusion nor infiltrative cardiomyopathy. Tests were performed to rule out secondary causes of hypereosinophilia, all of which were negative, and after comprehensive hematological studies, the diagnosis was IHES. Response to prednisone 1<span class="elsevierStyleHsp" style=""></span>mg/kg was favorable. The eosinophilia abated initially in peripheral blood and subsequently, after 7 months, in PE. Eosinophil levels in normal PF are low (less than 1%). High levels can be due to multiple causes. The most common causes of EPE are malignant (around 30%–34%<a class="elsevierStyleCrossRefs" href="#bib0030"><span class="elsevierStyleSup">1,2</span></a>), parapneumonic, and tuberculous effusion. Other possible etiologies include asbestos, drug toxicities, parasitical infections, and Churg-Strauss syndrome, or less commonly, viral infections and pulmonary embolism.<a class="elsevierStyleCrossRef" href="#bib0040"><span class="elsevierStyleSup">3</span></a> Very little information is available on EPE due to IHES or causes other than those mentioned, as can be surmised from the few cases reported to date.<a class="elsevierStyleCrossRef" href="#bib0045"><span class="elsevierStyleSup">4</span></a> The particular interest in this patient is that the disease started only as relapsing EPE. In one of the published cases, the patient had hepatosplenomegaly and ascites combined with bilateral PE, and unlike our patient, the outcome was death. In addition to bilateral EPE, the other patient presented skin lesions which were found to be due to vasculitis.<a class="elsevierStyleCrossRef" href="#bib0050"><span class="elsevierStyleSup">5</span></a></p><elsevierMultimedia ident="fig0005"></elsevierMultimedia><p id="par0015" class="elsevierStylePara elsevierViewall">When EPE with no apparent etiology is observed, IHES must be considered. Eosinophilia in peripheral blood in the absence of other manifestations should alert to the presence of this entity. Close collaboration with the hematologist is necessary to confirm the etiology of this finding.</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: Lima Álvarez J, Peña Griñán N, Simón Pilo I. Derrame pleural eosinofílico secundario a síndrome hipereosinofílico idiopático. Arch Bronconeumol. 2016;52:538.</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" => 570 "Ancho" => 953 "Tamanyo" => 66698 ] ] "descripcion" => array:1 [ "en" => "<p id="spar0005" class="elsevierStyleSimplePara elsevierViewall">Chest computed tomography showing bilateral pleural effusion with lack of pulmonary involvement.</p>" ] ] ] "bibliografia" => array:2 [ "titulo" => "References" "seccion" => array:1 [ 0 => array:2 [ "identificador" => "bibs0005" "bibliografiaReferencia" => array:5 [ 0 => array:3 [ "identificador" => "bib0030" "etiqueta" => "1" "referencia" => array:1 [ 0 => array:2 [ "contribucion" => array:1 [ 0 => array:2 [ "titulo" => "Eosinophilic pleural effusion: incidence, etiology and prognostic significance" "autores" => array:1 [ 0 => array:2 [ "etal" => true "autores" => array:6 [ 0 => "L. 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Brune" ] ] ] ] ] "host" => array:1 [ 0 => array:1 [ "Revista" => array:6 [ "tituloSerie" => "Eur Respir J" "fecha" => "1990" "volumen" => "3" "paginaInicial" => "115" "paginaFinal" => "118" "link" => array:1 [ 0 => array:2 [ "url" => "https://www.ncbi.nlm.nih.gov/pubmed/2178960" "web" => "Medline" ] ] ] ] ] ] ] ] ] ] ] ] ] "idiomaDefecto" => "en" "url" => "/15792129/0000005200000010/v2_201609300109/S157921291630180X/v2_201609300109/en/main.assets" "Apartado" => array:4 [ "identificador" => "49861" "tipo" => "SECCION" "en" => array:2 [ "titulo" => "Scientific letters" "idiomaDefecto" => true ] "idiomaDefecto" => "en" ] "PDF" => "https://static.elsevier.es/multimedia/15792129/0000005200000010/v2_201609300109/S157921291630180X/v2_201609300109/en/main.pdf?idApp=UINPBA00003Z&text.app=https://archbronconeumol.org/" "EPUB" => "https://multimedia.elsevier.es/PublicationsMultimediaV1/item/epub/S157921291630180X?idApp=UINPBA00003Z" ]
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2017 July | 23 | 8 | 31 |
2017 June | 18 | 16 | 34 |
2017 May | 29 | 13 | 42 |
2017 April | 23 | 14 | 37 |
2017 March | 13 | 10 | 23 |
2017 February | 11 | 8 | 19 |
2017 January | 11 | 8 | 19 |