Clinical Image
Plastic Bronchitis in a Patient With Silicosis
Bronquitis plástica en un paciente con 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, Spain" "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, Spain" "etiqueta" => "b" "identificador" => "aff0010" ] ] "correspondencia" => array:1 [ 0 => array:3 [ "identificador" => "cor0005" "etiqueta" => "⁎" "correspondencia" => "Corresponding author." ] ] ] ] "titulosAlternativos" => array:1 [ "es" => array:1 [ "titulo" => "Bronquitis plástica en un paciente con silicosis" ] ] "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" => 1401 "Ancho" => 956 "Tamanyo" => 160163 ] ] "descripcion" => array:1 [ "en" => "<p id="spar0005" class="elsevierStyleSimplePara elsevierViewall">(a) Interstitial pattern with bilateral conglomerates and (b) expectorated bronchial cast.</p>" ] ] ] "textoCompleto" => "<span class="elsevierStyleSections"><p id="par0005" class="elsevierStylePara elsevierViewall">We report the case of a 49-year-old man with complicated silicosis and a history of pulmonary tuberculosis, non-smoker, with obstructive airflow limitation. He consulted due to episodes of intense dyspnea coinciding with expectoration of thick bloody secretions with a similar appearance to the bronchial tree (<a class="elsevierStyleCrossRef" href="#fig0005">Fig. 1</a>), occurring several days a week. The fiberoptic bronchoscopy showed no relevant findings and the pathology study of the bronchial cast revealed fibrinoinflammatory mucoid material, with abundant histiocytes.</p><elsevierMultimedia ident="fig0005"></elsevierMultimedia><p id="par0010" class="elsevierStylePara elsevierViewall">Plastic bronchitis (PB) is a rare lung disease characterized by the formation and expectoration of bronchial casts that obstruct the bronchial lumen.<a class="elsevierStyleCrossRef" href="#bib0015"><span class="elsevierStyleSup">1</span></a> It has been described as a complication of primary lymphatic abnormalities in patients with congenital heart disease (after the Fontan procedure), respiratory infections, cystic fibrosis, COPD, and allergic bronchopulmonary aspergillosis.<a class="elsevierStyleCrossRef" href="#bib0015"><span class="elsevierStyleSup">1</span></a> We report a case of PB associated with silicosis. Treatment is controversial and therapeutic choices, which are based on isolated case reports, include mainly dornase alfa, low-dose macrolides, and nebulized hypertonic saline and acetylcysteine. Response to inhalation of fibrinolytics and nebulized heparin has been reported.<a class="elsevierStyleCrossRefs" href="#bib0015"><span class="elsevierStyleSup">1,2</span></a> In our patient, episodes of mucus plug expulsion reduced notably with the administration of prednisone (15<span class="elsevierStyleHsp" style=""></span>mg/day) and nebulized heparin sodium (5000<span class="elsevierStyleHsp" style=""></span>IU/12<span class="elsevierStyleHsp" style=""></span>h).</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: Blanco Pérez JJ, Arnalich Montiel V, Guerra Vales JL. Bronquitis plástica en un paciente con silicosis. Arch Bronconeumol. 2017;53:516.</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" => 1401 "Ancho" => 956 "Tamanyo" => 160163 ] ] "descripcion" => array:1 [ "en" => "<p id="spar0005" class="elsevierStyleSimplePara elsevierViewall">(a) Interstitial pattern with bilateral conglomerates and (b) expectorated bronchial cast.</p>" ] ] ] "bibliografia" => array:2 [ "titulo" => "References" "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:7 [ "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" ] ] "itemHostRev" => array:3 [ "pii" => "S147444220501015X" "estado" => "S300" "issn" => "14744422" ] ] ] ] ] ] ] ] ] ] ] ] "idiomaDefecto" => "en" "url" => "/15792129/0000005300000009/v2_201708291344/S1579212917302215/v2_201708291344/en/main.assets" "Apartado" => array:4 [ "identificador" => "60604" "tipo" => "SECCION" "en" => array:2 [ "titulo" => "Clinical Images" "idiomaDefecto" => true ] "idiomaDefecto" => "en" ] "PDF" => "https://static.elsevier.es/multimedia/15792129/0000005300000009/v2_201708291344/S1579212917302215/v2_201708291344/en/main.pdf?idApp=UINPBA00003Z&text.app=https://archbronconeumol.org/" "EPUB" => "https://multimedia.elsevier.es/PublicationsMultimediaV1/item/epub/S1579212917302215?idApp=UINPBA00003Z" ]
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