array:24 [
  "pii" => "S1579212920302834"
  "issn" => "15792129"
  "doi" => "10.1016/j.arbr.2020.06.009"
  "estado" => "S300"
  "fechaPublicacion" => "2020-12-01"
  "aid" => "2551"
  "copyright" => "SEPAR"
  "copyrightAnyo" => "2020"
  "documento" => "simple-article"
  "crossmark" => 1
  "subdocumento" => "crp"
  "cita" => "Arch Bronconeumol. 2020;56:820-1"
  "abierto" => array:3 [
    "ES" => false
    "ES2" => false
    "LATM" => false
  ]
  "gratuito" => false
  "lecturas" => array:1 [
    "total" => 0
  ]
  "Traduccion" => array:1 [
    "es" => array:19 [
      "pii" => "S0300289620302246"
      "issn" => "03002896"
      "doi" => "10.1016/j.arbres.2020.06.020"
      "estado" => "S300"
      "fechaPublicacion" => "2020-12-01"
      "aid" => "2551"
      "copyright" => "SEPAR"
      "documento" => "simple-article"
      "crossmark" => 1
      "subdocumento" => "crp"
      "cita" => "Arch Bronconeumol. 2020;56:820-1"
      "abierto" => array:3 [
        "ES" => true
        "ES2" => true
        "LATM" => true
      ]
      "gratuito" => true
      "lecturas" => array:1 [
        "total" => 0
      ]
      "es" => array:11 [
        "idiomaDefecto" => true
        "cabecera" => "<span class="elsevierStyleTextfn">Carta Cient&#237;fica</span>"
        "titulo" => "Hipertensi&#243;n pulmonar grave como inicio de la enfermedad metab&#243;lica"
        "tienePdf" => "es"
        "tieneTextoCompleto" => "es"
        "paginas" => array:1 [
          0 => array:2 [
            "paginaInicial" => "820"
            "paginaFinal" => "821"
          ]
        ]
        "titulosAlternativos" => array:1 [
          "en" => array:1 [
            "titulo" => "Severe Pulmonary Hypertension as the Debut of Metabolic Disease"
          ]
        ]
        "contieneTextoCompleto" => array:1 [
          "es" => true
        ]
        "contienePdf" => array:1 [
          "es" => true
        ]
        "resumenGrafico" => array:2 [
          "original" => 0
          "multimedia" => array:7 [
            "identificador" => "fig0010"
            "etiqueta" => "Figura 2"
            "tipo" => "MULTIMEDIAFIGURA"
            "mostrarFloat" => true
            "mostrarDisplay" => false
            "figura" => array:1 [
              0 => array:4 [
                "imagen" => "gr2.jpeg"
                "Alto" => 2606
                "Ancho" => 6096
                "Tamanyo" => 316964
              ]
            ]
            "descripcion" => array:1 [
              "es" => "<p id="spar0010" class="elsevierStyleSimplePara elsevierViewall">Izquierda&#58; Resonancia magn&#233;tica &#40;RM&#41; cerebral&#46; Secuencia de difusi&#243;n&#44; corte axial&#46; Se aprecia hiperse&#241;al difusa de la sustancia blanca&#46; Derecha&#58; Espectroscopia de RM cerebral&#46; Pico de glicina en sustancia blanca parietal derecha&#46;</p>"
            ]
          ]
        ]
        "autores" => array:1 [
          0 => array:2 [
            "autoresLista" => "Lorena Estepa Pedregosa, Carmina Guitart Pardellans, Benjamin Jaume Baucells Lokyer, Fredy Herm&#243;genes Prada Mart&#237;nez, &#192;ngels Garc&#237;a Cazorla, Francisco Jos&#233; Cambra Lasaosa, Susana Segura Matute"
            "autores" => array:7 [
              0 => array:2 [
                "nombre" => "Lorena"
                "apellidos" => "Estepa Pedregosa"
              ]
              1 => array:2 [
                "nombre" => "Carmina"
                "apellidos" => "Guitart Pardellans"
              ]
              2 => array:2 [
                "nombre" => "Benjamin Jaume"
                "apellidos" => "Baucells Lokyer"
              ]
              3 => array:2 [
                "nombre" => "Fredy Herm&#243;genes"
                "apellidos" => "Prada Mart&#237;nez"
              ]
              4 => array:2 [
                "nombre" => "&#192;ngels"
                "apellidos" => "Garc&#237;a Cazorla"
              ]
              5 => array:2 [
                "nombre" => "Francisco Jos&#233;"
                "apellidos" => "Cambra Lasaosa"
              ]
              6 => array:2 [
                "nombre" => "Susana"
                "apellidos" => "Segura Matute"
              ]
            ]
          ]
        ]
      ]
      "idiomaDefecto" => "es"
      "Traduccion" => array:1 [
        "en" => array:9 [
          "pii" => "S1579212920302834"
          "doi" => "10.1016/j.arbr.2020.06.009"
          "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/S1579212920302834?idApp=UINPBA00003Z"
        ]
      ]
      "EPUB" => "https://multimedia.elsevier.es/PublicationsMultimediaV1/item/epub/S0300289620302246?idApp=UINPBA00003Z"
      "url" => "/03002896/0000005600000012/v1_202012050807/S0300289620302246/v1_202012050807/es/main.assets"
    ]
  ]
  "itemSiguiente" => array:18 [
    "pii" => "S157921292030344X"
    "issn" => "15792129"
    "doi" => "10.1016/j.arbr.2020.06.014"
    "estado" => "S300"
    "fechaPublicacion" => "2020-12-01"
    "aid" => "2552"
    "copyright" => "SEPAR"
    "documento" => "simple-article"
    "crossmark" => 1
    "subdocumento" => "crp"
    "cita" => "Arch Bronconeumol. 2020;56:822-3"
    "abierto" => array:3 [
      "ES" => false
      "ES2" => false
      "LATM" => false
    ]
    "gratuito" => false
    "lecturas" => array:1 [
      "total" => 0
    ]
    "en" => array:11 [
      "idiomaDefecto" => true
      "cabecera" => "<span class="elsevierStyleTextfn">Scientific Letter</span>"
      "titulo" => "Osimertinib for the Treatment of EGFR Mutation-Positive Lung Adenocarcinoma Complicated With Dermatomyositis"
      "tienePdf" => "en"
      "tieneTextoCompleto" => "en"
      "paginas" => array:1 [
        0 => array:2 [
          "paginaInicial" => "822"
          "paginaFinal" => "823"
        ]
      ]
      "titulosAlternativos" => array:1 [
        "es" => array:1 [
          "titulo" => "El osimertinib como tratamiento del adenocarcinoma de pulm&#243;n con mutaci&#243;n positiva del EGFR complicado con dermatomiositis"
        ]
      ]
      "contieneTextoCompleto" => array:1 [
        "en" => true
      ]
      "contienePdf" => array:1 [
        "en" => true
      ]
      "resumenGrafico" => array:2 [
        "original" => 0
        "multimedia" => array:7 [
          "identificador" => "fig0005"
          "etiqueta" => "Fig&#46; 1"
          "tipo" => "MULTIMEDIAFIGURA"
          "mostrarFloat" => true
          "mostrarDisplay" => false
          "figura" => array:1 [
            0 => array:4 [
              "imagen" => "gr1.jpeg"
              "Alto" => 881
              "Ancho" => 1600
              "Tamanyo" => 212565
            ]
          ]
          "descripcion" => array:1 [
            "en" => "<p id="spar0005" class="elsevierStyleSimplePara elsevierViewall">&#40;A&#44; B&#41; Dermatological findings after the first examination of the patient&#46; &#40;A&#41; Visible erythema over both eyelids &#40;heliotrope rash&#41; with facial edema&#46; &#40;B&#41; Papules &#40;Gottron&#39;s papules&#41; and edema on the dorsal surface of the hands are visible&#46; &#40;C&#41; Chest computed tomography &#40;CT&#41; scan showing primary lesion in the right lung&#44; lower lobe &#40;arrow&#41;&#46; &#40;D&#41; Chest CT scan showing mediastinal lymphadenopathy&#46;</p>"
          ]
        ]
      ]
      "autores" => array:1 [
        0 => array:2 [
          "autoresLista" => "Masahiro Yamasaki, Naoko Matsumoto, Shota Nakano, Kazuma Kawamoto, Masaya Taniwaki, Yusuke Izumi, Masaya Otohara, Shinji Nabeshima, Nobuyuki Ohashi, Noboru Hattori"
          "autores" => array:10 [
            0 => array:2 [
              "nombre" => "Masahiro"
              "apellidos" => "Yamasaki"
            ]
            1 => array:2 [
              "nombre" => "Naoko"
              "apellidos" => "Matsumoto"
            ]
            2 => array:2 [
              "nombre" => "Shota"
              "apellidos" => "Nakano"
            ]
            3 => array:2 [
              "nombre" => "Kazuma"
              "apellidos" => "Kawamoto"
            ]
            4 => array:2 [
              "nombre" => "Masaya"
              "apellidos" => "Taniwaki"
            ]
            5 => array:2 [
              "nombre" => "Yusuke"
              "apellidos" => "Izumi"
            ]
            6 => array:2 [
              "nombre" => "Masaya"
              "apellidos" => "Otohara"
            ]
            7 => array:2 [
              "nombre" => "Shinji"
              "apellidos" => "Nabeshima"
            ]
            8 => array:2 [
              "nombre" => "Nobuyuki"
              "apellidos" => "Ohashi"
            ]
            9 => array:2 [
              "nombre" => "Noboru"
              "apellidos" => "Hattori"
            ]
          ]
        ]
      ]
    ]
    "idiomaDefecto" => "en"
    "EPUB" => "https://multimedia.elsevier.es/PublicationsMultimediaV1/item/epub/S157921292030344X?idApp=UINPBA00003Z"
    "url" => "/15792129/0000005600000012/v1_202012151701/S157921292030344X/v1_202012151701/en/main.assets"
  ]
  "itemAnterior" => array:19 [
    "pii" => "S1579212920302822"
    "issn" => "15792129"
    "doi" => "10.1016/j.arbr.2020.06.008"
    "estado" => "S300"
    "fechaPublicacion" => "2020-12-01"
    "aid" => "2549"
    "copyright" => "SEPAR"
    "documento" => "article"
    "crossmark" => 1
    "subdocumento" => "crp"
    "cita" => "Arch Bronconeumol. 2020;56:818-9"
    "abierto" => array:3 [
      "ES" => false
      "ES2" => false
      "LATM" => false
    ]
    "gratuito" => false
    "lecturas" => array:1 [
      "total" => 0
    ]
    "en" => array:10 [
      "idiomaDefecto" => true
      "cabecera" => "<span class="elsevierStyleTextfn">Scientific Letter</span>"
      "titulo" => "Study of adherence to continuous positive airway pressure treatment in patients with obstructive sleep apnea syndrome in the confinement during the COVID-19 pandemic"
      "tienePdf" => "en"
      "tieneTextoCompleto" => "en"
      "paginas" => array:1 [
        0 => array:2 [
          "paginaInicial" => "818"
          "paginaFinal" => "819"
        ]
      ]
      "titulosAlternativos" => array:1 [
        "es" => array:1 [
          "titulo" => "Estudio de la adherencia al tratamiento con presi&#243;n continua positiva en la v&#237;a a&#233;rea en pacientes con s&#237;ndrome de apnea obstructiva del sue&#241;o en el confinamiento impuesto durante la pandemia de COVID-19"
        ]
      ]
      "contieneTextoCompleto" => array:1 [
        "en" => true
      ]
      "contienePdf" => array:1 [
        "en" => true
      ]
      "autores" => array:1 [
        0 => array:2 [
          "autoresLista" => "F&#233;lix del Campo, Graciela L&#243;pez, C&#46; Ainhoa Arroyo, Julio F&#46; de Frutos, Andrea Crespo, Ana Cerezo-Hern&#225;ndez, Tania M&#46; &#193;lvaro, Tom&#225;s Ruiz, Fernando Moreno, Gonzalo C&#46; Guti&#233;rrez-Tobal, Roberto Hornero, Daniel &#193;lvarez"
          "autores" => array:12 [
            0 => array:2 [
              "nombre" => "F&#233;lix"
              "apellidos" => "del Campo"
            ]
            1 => array:2 [
              "nombre" => "Graciela"
              "apellidos" => "L&#243;pez"
            ]
            2 => array:2 [
              "nombre" => "C&#46; Ainhoa"
              "apellidos" => "Arroyo"
            ]
            3 => array:2 [
              "nombre" => "Julio F&#46;"
              "apellidos" => "de Frutos"
            ]
            4 => array:2 [
              "nombre" => "Andrea"
              "apellidos" => "Crespo"
            ]
            5 => array:2 [
              "nombre" => "Ana"
              "apellidos" => "Cerezo-Hern&#225;ndez"
            ]
            6 => array:2 [
              "nombre" => "Tania M&#46;"
              "apellidos" => "&#193;lvaro"
            ]
            7 => array:2 [
              "nombre" => "Tom&#225;s"
              "apellidos" => "Ruiz"
            ]
            8 => array:2 [
              "nombre" => "Fernando"
              "apellidos" => "Moreno"
            ]
            9 => array:2 [
              "nombre" => "Gonzalo C&#46;"
              "apellidos" => "Guti&#233;rrez-Tobal"
            ]
            10 => array:2 [
              "nombre" => "Roberto"
              "apellidos" => "Hornero"
            ]
            11 => array:2 [
              "nombre" => "Daniel"
              "apellidos" => "&#193;lvarez"
            ]
          ]
        ]
      ]
    ]
    "idiomaDefecto" => "en"
    "Traduccion" => array:1 [
      "es" => array:9 [
        "pii" => "S0300289620302222"
        "doi" => "10.1016/j.arbres.2020.06.019"
        "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/S0300289620302222?idApp=UINPBA00003Z"
      ]
    ]
    "EPUB" => "https://multimedia.elsevier.es/PublicationsMultimediaV1/item/epub/S1579212920302822?idApp=UINPBA00003Z"
    "url" => "/15792129/0000005600000012/v1_202012151701/S1579212920302822/v1_202012151701/en/main.assets"
  ]
  "en" => array:17 [
    "idiomaDefecto" => true
    "cabecera" => "<span class="elsevierStyleTextfn">Scientific Letter</span>"
    "titulo" => "Severe Pulmonary Hypertension as the Debut of Metabolic Disease"
    "tieneTextoCompleto" => true
    "saludo" => "To the Editor&#44;"
    "paginas" => array:1 [
      0 => array:2 [
        "paginaInicial" => "820"
        "paginaFinal" => "821"
      ]
    ]
    "autores" => array:1 [
      0 => array:4 [
        "autoresLista" => "Lorena Estepa Pedregosa, Carmina Guitart Pardellans, Benjamin Jaume Baucells Lokyer, Fredy Herm&#243;genes Prada Mart&#237;nez, &#192;ngels Garc&#237;a Cazorla, Francisco Jos&#233; Cambra Lasaosa, Susana Segura Matute"
        "autores" => array:7 [
          0 => array:3 [
            "nombre" => "Lorena"
            "apellidos" => "Estepa Pedregosa"
            "referencia" => array:1 [
              0 => array:2 [
                "etiqueta" => "<span class="elsevierStyleSup">a</span>"
                "identificador" => "aff0005"
              ]
            ]
          ]
          1 => array:4 [
            "nombre" => "Carmina"
            "apellidos" => "Guitart Pardellans"
            "email" => array:1 [
              0 => "cguitart@sjdhospitalbarcelona.org"
            ]
            "referencia" => array:2 [
              0 => array:2 [
                "etiqueta" => "<span class="elsevierStyleSup">b</span>"
                "identificador" => "aff0010"
              ]
              1 => array:2 [
                "etiqueta" => "&#42;"
                "identificador" => "cor0005"
              ]
            ]
          ]
          2 => array:3 [
            "nombre" => "Benjamin Jaume"
            "apellidos" => "Baucells Lokyer"
            "referencia" => array:1 [
              0 => array:2 [
                "etiqueta" => "<span class="elsevierStyleSup">c</span>"
                "identificador" => "aff0015"
              ]
            ]
          ]
          3 => array:3 [
            "nombre" => "Fredy Herm&#243;genes"
            "apellidos" => "Prada Mart&#237;nez"
            "referencia" => array:1 [
              0 => array:2 [
                "etiqueta" => "<span class="elsevierStyleSup">d</span>"
                "identificador" => "aff0020"
              ]
            ]
          ]
          4 => array:3 [
            "nombre" => "&#192;ngels"
            "apellidos" => "Garc&#237;a Cazorla"
            "referencia" => array:2 [
              0 => array:2 [
                "etiqueta" => "<span class="elsevierStyleSup">e</span>"
                "identificador" => "aff0025"
              ]
              1 => array:2 [
                "etiqueta" => "<span class="elsevierStyleSup">f</span>"
                "identificador" => "aff0030"
              ]
            ]
          ]
          5 => array:3 [
            "nombre" => "Francisco Jos&#233;"
            "apellidos" => "Cambra Lasaosa"
            "referencia" => array:1 [
              0 => array:2 [
                "etiqueta" => "<span class="elsevierStyleSup">b</span>"
                "identificador" => "aff0010"
              ]
            ]
          ]
          6 => array:3 [
            "nombre" => "Susana"
            "apellidos" => "Segura Matute"
            "referencia" => array:1 [
              0 => array:2 [
                "etiqueta" => "<span class="elsevierStyleSup">b</span>"
                "identificador" => "aff0010"
              ]
            ]
          ]
        ]
        "afiliaciones" => array:6 [
          0 => array:3 [
            "entidad" => "Unidad de Cuidados Intensivos Pedi&#225;tricos &#40;UCIP&#41;&#44; Hospital Universitario Puerta del Mar&#44; C&#225;diz&#44; Spain"
            "etiqueta" => "a"
            "identificador" => "aff0005"
          ]
          1 => array:3 [
            "entidad" => "Unidad de Cuidados Intensivos Pedi&#225;tricos &#40;UCIP&#41;&#44; Hospital Sant Joan de D&#233;u&#46; Institut de Recerca H&#46; Sant Joan de D&#233;u&#44; Barcelona&#44; Spain"
            "etiqueta" => "b"
            "identificador" => "aff0010"
          ]
          2 => array:3 [
            "entidad" => "Servicio de Pediatr&#237;a&#44; Hospital Sant Joan de D&#233;u&#46; Institut de Recerca H&#46; Sant Joan de D&#233;u&#44; Barcelona&#44; Spain"
            "etiqueta" => "c"
            "identificador" => "aff0015"
          ]
          3 => array:3 [
            "entidad" => "Departamento de Cardiolog&#237;a&#44; Hospital Sant Joan de D&#233;u&#46; Institut de Recerca H&#46; Sant Joan de D&#233;u&#44; Barcelona&#44; Spain"
            "etiqueta" => "d"
            "identificador" => "aff0020"
          ]
          4 => array:3 [
            "entidad" => "Departamento de Gen&#233;tica y Medicina Molecular&#44; Hospital Sant Joan de D&#233;u y CIBERER&#44; Barcelona&#44; Spain"
            "etiqueta" => "e"
            "identificador" => "aff0025"
          ]
          5 => array:3 [
            "entidad" => "Departamento de Neurolog&#237;a&#44; Unidad de Enfermedades Neurometab&#243;licas&#44; Hospital Sant Joan de D&#233;u and CIBERER&#44; Barcelona&#44; Spain"
            "etiqueta" => "f"
            "identificador" => "aff0030"
          ]
        ]
        "correspondencia" => array:1 [
          0 => array:3 [
            "identificador" => "cor0005"
            "etiqueta" => "&#8270;"
            "correspondencia" => "Corresponding author&#46;"
          ]
        ]
      ]
    ]
    "titulosAlternativos" => array:1 [
      "es" => array:1 [
        "titulo" => "Hipertensi&#243;n pulmonar grave como inicio de la enfermedad metab&#243;lica"
      ]
    ]
    "resumenGrafico" => array:2 [
      "original" => 0
      "multimedia" => array:8 [
        "identificador" => "fig0010"
        "etiqueta" => "Fig&#46; 2"
        "tipo" => "MULTIMEDIAFIGURA"
        "mostrarFloat" => true
        "mostrarDisplay" => false
        "figura" => array:1 [
          0 => array:4 [
            "imagen" => "gr2.jpeg"
            "Alto" => 2606
            "Ancho" => 6096
            "Tamanyo" => 316964
          ]
        ]
        "detalles" => array:1 [
          0 => array:3 [
            "identificador" => "at0010"
            "detalle" => "Fig&#46; "
            "rol" => "short"
          ]
        ]
        "descripcion" => array:1 [
          "en" => "<p id="spar0010" class="elsevierStyleSimplePara elsevierViewall">Left&#58; Brain magnetic resonance imaging &#40;MRI&#41;&#46; Diffusion sequence&#44; axial slice&#46; Diffuse hypersignal in white matter&#46; Right&#58; Brain MR spectroscopy&#46; Glycine peak in right parietal white substance&#46;</p>"
        ]
      ]
    ]
    "textoCompleto" => "<span class="elsevierStyleSections"><p id="par0005" class="elsevierStylePara elsevierViewall">We report the case of a 6-month-old boy with severe pulmonary hypertension &#40;PHT&#41; who presented clinical worsening with acute pulmonary edema &#40;APE&#41; after starting conventional vasodilator treatment&#46; He was referred from another center for a second opinion and to complete the PHT study&#46; Parental consent was obtained for the publication of this case report and images&#46;</p><p id="par0010" class="elsevierStylePara elsevierViewall">The patient was monitored during gestation&#44; and had negative serologies and normal ultrasound scans&#46; He was delivered at term with an appropriate weight for his gestational age and no perinatal incidents&#46; Family history was significant for a spontaneous abortion and 2 healthy living siblings from the mother&#46; At 3 months of age&#44; he began to develop difficulty with ingestion&#44; growth impairment&#44; and hypotonia with mild psychomotor retardation&#46;</p><p id="par0015" class="elsevierStylePara elsevierViewall">He was admitted to the ward and received oxygen therapy&#44; oral sildenafil&#44; and inhaled prostacyclins&#46; After 5 days&#44; his situation suddenly worsened with desaturation and low cardiac output&#44; so he was transferred to the pediatric ICU&#46; Mechanical ventilation began with a FiO<span class="elsevierStyleInf">2</span> of 1&#44; nitric oxide up to 20&#8239;ppm&#44; and inotropic support with dopamine&#46; X-ray revealed Kerley B-lines and mottled perihilar infiltrates&#44; while thoracic ultrasound showed homogeneous increase in B-lines&#44; with no condensations or pleural effusion&#46; Echocardiography showed signs of severe PHT &#40;<a class="elsevierStyleCrossRef" href="#fig0005">Fig&#46; 1</a>&#41; with an estimated pulmonary artery pressure &#40;PAP&#41; of 70&#8239;mmHg &#40;normal value &#91;NV&#93;&#8239;&#60;&#8239;20&#8239;mmHg&#41;&#46; Cardiac catheterization was performed which showed&#58; systolic PAP&#47;diastolic &#40;mean&#41; PAP of 53&#47;24 &#40;38&#41; mmHg &#40;NV systolic PAP&#8239;&#60;&#8239;35&#8239;mmHg&#44; mean PAP&#8239;&#60;&#8239;20&#8239;mmHg&#41;&#44;<a class="elsevierStyleCrossRef" href="#bib0005"><span class="elsevierStyleSup">1</span></a> pulmonary resistances of 8&#46;51 Wood units&#47;m<span class="elsevierStyleSup">2</span> &#40;NV&#8239;&#60;&#8239;3&#8239;WU&#47;m<span class="elsevierStyleSup">2</span>&#41;&#44; and pulmonary artery wedge pressure &#40;PWP&#41; of 10&#8239;mmHg &#40;NV&#8239;&#60;&#8239;15&#8239;mmHg&#41;&#46;<a class="elsevierStyleCrossRef" href="#bib0005"><span class="elsevierStyleSup">1</span></a> Left heart changes were thus excluded as the cause of PHT&#46;</p><elsevierMultimedia ident="fig0005"></elsevierMultimedia><p id="par0020" class="elsevierStylePara elsevierViewall">The metabolic study was expanded&#44; showing hyperlactacidemia with 8&#46;1&#8239;mmol&#47;L lactate &#40;NV&#8239;&#60;&#8239;2&#8239;mmol&#47;L&#41; and no metabolic acidosis or ketosis&#44; increased blood glycine of 1&#44;599&#8239;&#181;mol&#47;L &#40;NV 109-293&#8239;&#956;mol&#47;L&#41;&#44; and 83&#46;1&#8239;&#956;mol cerebrospinal fluid &#40;CSF&#41; &#40;NV 3-13&#8239;&#956;mol&#41;&#46; Non-ketotic hyperglycinemia &#40;NKHG&#41; was suspected&#44; and treatment began with thiamine&#44; sodium benzoate&#44; lipoic acid and acetyl cysteine&#44; and brain magnetic resonance imaging &#40;MRI&#41; was performed &#40;<a class="elsevierStyleCrossRef" href="#fig0010">Fig&#46; 2</a>&#41;&#44; revealing reduced subcortical deep white matter&#44; while altered myelination with glycine peak in the right parietal white substance was observed on spectroscopy &#40;<a class="elsevierStyleCrossRef" href="#fig0010">Fig&#46; 2</a>&#41;&#46;</p><elsevierMultimedia ident="fig0010"></elsevierMultimedia><p id="par0025" class="elsevierStylePara elsevierViewall">Despite all efforts&#44; the patient&#8217;s severe PHT persisted and he died 28 days after admission&#46; The result of the genetic study was received 2 weeks later&#44; confirming mutation in the NFU1 gene &#40;c&#46;565&#8239;G&#8239;&#62;&#8239;A&#44; p&#46;Gly189Arg&#41;&#44; described in the literature as pathogenic&#44; causing mitochondrial dysfunction in multiple organs&#46;</p><p id="par0030" class="elsevierStylePara elsevierViewall">PHT is rare in pediatrics and mainly associated with inborn errors of metabolism&#46; Prognosis in these cases is fatal&#46;<a class="elsevierStyleCrossRefs" href="#bib0005"><span class="elsevierStyleSup">1&#44;2</span></a> In all infants with PHT&#44; any association with metabolic disease should be ruled out&#44; as PHT may appear before neurological manifestations&#46;<a class="elsevierStyleCrossRef" href="#bib0015"><span class="elsevierStyleSup">3</span></a> Specifically&#44; if the patient develops associated neurological manifestations&#44; signs of multiorgan failure&#44; or if APE occurs with conventional treatment&#44;<a class="elsevierStyleCrossRefs" href="#bib0010"><span class="elsevierStyleSup">2&#8211;7</span></a> a metabolic study should be performed to check for an increase in glycine levels in plasma&#44; CSF and urine&#44; as was performed in our patient&#46;<a class="elsevierStyleCrossRefs" href="#bib0010"><span class="elsevierStyleSup">2&#44;4&#8211;6</span></a> The combined defect of pyruvate dehydrogenase complex activity and different respiratory chain complexes in skeletal muscle&#44; skin fibroblasts and liver has also been defined&#46;<a class="elsevierStyleCrossRefs" href="#bib0010"><span class="elsevierStyleSup">2&#44;4&#8211;6</span></a></p><p id="par0035" class="elsevierStylePara elsevierViewall">So far&#44; 3 phenotypes associated with either neurological or respiratory symptoms or both have been described&#46;<a class="elsevierStyleCrossRef" href="#bib0010"><span class="elsevierStyleSup">2</span></a> In our case&#44; the patient had PHT with hypotonia and slightly delayed psychomotor development&#44; so he could be included in the third group&#46; As in the cases described in the literature&#44; leukoencephalopathy was observed on MRI and glycine peak was seen in the right parietal lobe&#46;<a class="elsevierStyleCrossRefs" href="#bib0010"><span class="elsevierStyleSup">2&#44;4&#8211;6</span></a></p><p id="par0040" class="elsevierStylePara elsevierViewall">In the series described so far&#44; the onset of PHT occurs in the first 6 months of life&#44; it does not respond to usual treatment&#44; and the prognosis is unfavorable&#44; with the patient dying in the first 15 months of life&#46;<a class="elsevierStyleCrossRefs" href="#bib0010"><span class="elsevierStyleSup">2&#44;4</span></a> In addition&#44; clinical worsening after initiation of vasodilator treatment is described in all cases&#46;</p><p id="par0045" class="elsevierStylePara elsevierViewall">Invernizzi et al&#46; and Nizon et al&#46; published the case of 2 patients who survived longer&#44; dying at 30 months of age&#46;<a class="elsevierStyleCrossRefs" href="#bib0025"><span class="elsevierStyleSup">5&#44;6</span></a> Both cases were associated with the same allelic alteration of the NFU1 gene &#40;c&#46;565G&#8239;&#62;&#8239;A&#44; p&#46;Gly189Arg&#41;&#46; The other patients had different mutations of the NFU1 gene and died earlier&#46;</p><p id="par0050" class="elsevierStylePara elsevierViewall">Our patient&#8217;s genetic study revealed 2 mutations in the NFU1 gene&#46; One had been previously described as pathogenic &#40;P&#46;Gly208Cys&#47;c&#46;622G&#8239;&#62;&#8239;T&#41;&#44;<a class="elsevierStyleCrossRefs" href="#bib0010"><span class="elsevierStyleSup">2&#44;8&#8211;11</span></a> but the second sequenced mutation &#40;P&#46;Trp130Arg&#47;c&#46; 388T&#8239;&#62;&#8239;C&#41; was classified as a variant of uncertain meaning&#46; Since this mutation has not been previously described in a disease with recessive inheritance&#44; it should be considered in future research in case it is a pathogenic mutation&#46; NFU1 gene mutations cause mitochondrial dysfunction in multiple organs with an autosomal recessive pattern of inheritance&#46;</p><p id="par0055" class="elsevierStylePara elsevierViewall">NFU1 gene alterations decrease or eliminate the production of the protein involved in the formation of iron sulfide complexes that bind to certain proteins and are required for their proper function&#44; such as the production of mitochondrial energy and the decomposition of glycine&#46; This phenomenon explains the laboratory and clinical findings of our patient&#46;<a class="elsevierStyleCrossRef" href="#bib0010"><span class="elsevierStyleSup">2</span></a></p><p id="par0060" class="elsevierStylePara elsevierViewall">In conclusion&#44; PHT associated with inborn errors of metabolism is rare and confers a bleak prognosis&#46; It should be suspected in an infant with severe PHT and sometimes neurological symptoms&#44; who presents clinical worsening with PAE after initiation of conventional treatment&#44; and hyperlactacidemia without metabolic acidosis&#46; Therefore&#44; in all cases of idiopathic PHT&#44; metabolic studies should be performed&#46; It is important to reach a diagnosis in order to offer of genetic counseling because this disease is fatal and no curative treatment has been described to date&#46;</p></span>"
    "pdfFichero" => "main.pdf"
    "tienePdf" => true
    "fechaRecibido" => "2020-04-22"
    "fechaAceptado" => "2020-06-22"
    "NotaPie" => array:1 [
      0 => array:2 [
        "etiqueta" => "&#9734;"
        "nota" => "<p class="elsevierStyleNotepara" id="npar0005">Please cite this article as&#58; Estepa Pedregosa L&#44; Guitart Pardellans C&#44; Baucells Lokyer BJ&#44; Prada Mart&#237;nez FH&#44; Garc&#237;a Cazorla A&#44; Cambra Lasaosa FJ&#44; et al&#46; Hipertensi&#243;n pulmonar grave como inicio de la enfermedad metab&#243;lica&#46; Arch Bronconeumol&#46; 2020&#46; <span class="elsevierStyleInterRef" id="intr0005" href="https://doi.org/10.1016/j.arbres.2020.06.020">https&#58;&#47;&#47;doi&#46;org&#47;10&#46;1016&#47;j&#46;arbres&#46;2020&#46;06&#46;020</span></p>"
      ]
    ]
    "multimedia" => array:2 [
      0 => array:8 [
        "identificador" => "fig0005"
        "etiqueta" => "Fig&#46; 1"
        "tipo" => "MULTIMEDIAFIGURA"
        "mostrarFloat" => true
        "mostrarDisplay" => false
        "figura" => array:1 [
          0 => array:4 [
            "imagen" => "gr1.jpeg"
            "Alto" => 1193
            "Ancho" => 1625
            "Tamanyo" => 182453
          ]
        ]
        "detalles" => array:1 [
          0 => array:3 [
            "identificador" => "at0005"
            "detalle" => "Fig&#46; "
            "rol" => "short"
          ]
        ]
        "descripcion" => array:1 [
          "en" => "<p id="spar0005" class="elsevierStyleSimplePara elsevierViewall">Echocardiography&#46; 4-chamber view&#46; Dilated right cavities with interventricular septum deviated to the left&#46; Moderate tricuspid regurgitation with a gradient of 60&#8239;mmHg allowing estimation of a PAP of approximately 70&#8239;mmHg&#46; Interatrial septum with 5&#8239;mm patent foramen ovale&#46; Valves of normal morphology&#46;</p>"
        ]
      ]
      1 => array:8 [
        "identificador" => "fig0010"
        "etiqueta" => "Fig&#46; 2"
        "tipo" => "MULTIMEDIAFIGURA"
        "mostrarFloat" => true
        "mostrarDisplay" => false
        "figura" => array:1 [
          0 => array:4 [
            "imagen" => "gr2.jpeg"
            "Alto" => 2606
            "Ancho" => 6096
            "Tamanyo" => 316964
          ]
        ]
        "detalles" => array:1 [
          0 => array:3 [
            "identificador" => "at0010"
            "detalle" => "Fig&#46; "
            "rol" => "short"
          ]
        ]
        "descripcion" => array:1 [
          "en" => "<p id="spar0010" class="elsevierStyleSimplePara elsevierViewall">Left&#58; Brain magnetic resonance imaging &#40;MRI&#41;&#46; Diffusion sequence&#44; axial slice&#46; Diffuse hypersignal in white matter&#46; Right&#58; Brain MR spectroscopy&#46; Glycine peak in right parietal white substance&#46;</p>"
        ]
      ]
    ]
    "bibliografia" => array:2 [
      "titulo" => "References"
      "seccion" => array:1 [
        0 => array:2 [
          "identificador" => "bibs0005"
          "bibliografiaReferencia" => array:11 [
            0 => array:3 [
              "identificador" => "bib0005"
              "etiqueta" => "1"
              "referencia" => array:1 [
                0 => array:2 [
                  "contribucion" => array:1 [
                    0 => array:2 [
                      "titulo" => "Assessing pulmonary hypertensive vascular disease in childhood data from the Spanish Registry"
                      "autores" => array:1 [
                        0 => array:2 [
                          "etal" => true
                          "autores" => array:6 [
                            0 => "M&#46;J&#46; Del Cerro Mar&#237;n"
                            1 => "A&#46; Sabat&#233; Rot&#233;s"
                            2 => "A&#46; Rodriguez Orgando"
                            3 => "A&#46; Mendoza Soto"
                            4 => "M&#46; Quero Jim&#233;nez"
                            5 => "J&#46;L&#46; Gavil&#225;n Camacho"
                          ]
                        ]
                      ]
                    ]
                  ]
                  "host" => array:1 [
                    0 => array:2 [
                      "doi" => "10.1164/rccm.201406-1052OC"
                      "Revista" => array:6 [
                        "tituloSerie" => "Am J Respir Crit Care Med"
                        "fecha" => "2014"
                        "volumen" => "190"
                        "paginaInicial" => "1421"
                        "paginaFinal" => "1429"
                        "link" => array:1 [
                          0 => array:2 [
                            "url" => "https://www.ncbi.nlm.nih.gov/pubmed/25379685"
                            "web" => "Medline"
                          ]
                        ]
                      ]
                    ]
                  ]
                ]
              ]
            ]
            1 => array:3 [
              "identificador" => "bib0010"
              "etiqueta" => "2"
              "referencia" => array:1 [
                0 => array:2 [
                  "contribucion" => array:1 [
                    0 => array:2 [
                      "titulo" => "A fatal mitochondrial disease is associated with defective NFU1 function in the maturation of a subset of mitochondrial Fe&#8211;S proteins"
                      "autores" => array:1 [
                        0 => array:2 [
                          "etal" => true
                          "autores" => array:6 [
                            0 => "A&#46; Navarro-Sastre"
                            1 => "F&#46; Tort"
                            2 => "O&#46; Stehling"
                            3 => "M&#46;A&#46; Uzarska"
                            4 => "J&#46;A&#46; Arranz"
                            5 => "M&#46; Del Toro"
                          ]
                        ]
                      ]
                    ]
                  ]
                  "host" => array:1 [
                    0 => array:2 [
                      "doi" => "10.1016/j.ajhg.2011.10.005"
                      "Revista" => array:6 [
                        "tituloSerie" => "Am J Hum Genet"
                        "fecha" => "2011"
                        "volumen" => "89"
                        "paginaInicial" => "656"
                        "paginaFinal" => "667"
                        "link" => array:1 [
                          0 => array:2 [
                            "url" => "https://www.ncbi.nlm.nih.gov/pubmed/22077971"
                            "web" => "Medline"
                          ]
                        ]
                      ]
                    ]
                  ]
                ]
              ]
            ]
            2 => array:3 [
              "identificador" => "bib0015"
              "etiqueta" => "3"
              "referencia" => array:1 [
                0 => array:2 [
                  "contribucion" => array:1 [
                    0 => array:2 [
                      "titulo" => "Nonketotic hyperglycinemia presenting as pulmonary hypertensive vascular disease and fatal pulmonary edema in response to pulmonary vasodilator therapy"
                      "autores" => array:1 [
                        0 => array:2 [
                          "etal" => false
                          "autores" => array:6 [
                            0 => "J&#46;J&#46; Men&#233;ndez Suso"
                            1 => "M&#46;J&#46; del Cerro Mar&#237;n"
                            2 => "P&#46; Dorao Mart&#237;nez-Romillo"
                            3 => "C&#46; Labrandero de Lera"
                            4 => "L&#46; Fern&#225;ndez Garc&#237;a-Moya"
                            5 => "J&#46;I&#46; Rodr&#237;guez Gonz&#225;lez"
                          ]
                        ]
                      ]
                    ]
                  ]
                  "host" => array:1 [
                    0 => array:2 [
                      "doi" => "10.1016/j.jpeds.2012.04.044"
                      "Revista" => array:6 [
                        "tituloSerie" => "J Pediatr"
                        "fecha" => "2012"
                        "volumen" => "161"
                        "paginaInicial" => "557"
                        "paginaFinal" => "559"
                        "link" => array:1 [
                          0 => array:2 [
                            "url" => "https://www.ncbi.nlm.nih.gov/pubmed/22658788"
                            "web" => "Medline"
                          ]
                        ]
                      ]
                    ]
                  ]
                ]
              ]
            ]
            3 => array:3 [
              "identificador" => "bib0020"
              "etiqueta" => "4"
              "referencia" => array:1 [
                0 => array:2 [
                  "contribucion" => array:1 [
                    0 => array:2 [
                      "titulo" => "Clinical&#44; biochemical&#44; and genetic spectrum of seven patients with NFU1 deficiency"
                      "autores" => array:1 [
                        0 => array:2 [
                          "etal" => true
                          "autores" => array:6 [
                            0 => "U&#46; Ahting"
                            1 => "J&#46;A&#46; Mayr"
                            2 => "A&#46;V&#46; Vanlander"
                            3 => "S&#46;A&#46; Hardy"
                            4 => "S&#46; Santra"
                            5 => "C&#46; Makowski"
                          ]
                        ]
                      ]
                    ]
                  ]
                  "host" => array:1 [
                    0 => array:2 [
                      "doi" => "10.3389/fgene.2015.00123"
                      "Revista" => array:5 [
                        "tituloSerie" => "Front Genet"
                        "fecha" => "2015"
                        "volumen" => "6"
                        "paginaInicial" => "123"
                        "link" => array:1 [
                          0 => array:2 [
                            "url" => "https://www.ncbi.nlm.nih.gov/pubmed/25918518"
                            "web" => "Medline"
                          ]
                        ]
                      ]
                    ]
                  ]
                ]
              ]
            ]
            4 => array:3 [
              "identificador" => "bib0025"
              "etiqueta" => "5"
              "referencia" => array:1 [
                0 => array:2 [
                  "contribucion" => array:1 [
                    0 => array:2 [
                      "titulo" => "Cavitating leukoencephalopathy with multiple mitocondrial dysfunction s&#237;ndrome and NFU1mutations"
                      "autores" => array:1 [
                        0 => array:2 [
                          "etal" => true
                          "autores" => array:6 [
                            0 => "F&#46; Invernizzi"
                            1 => "A&#46; Ardissone"
                            2 => "E&#46; Lamantea"
                            3 => "B&#46; Garavaglia"
                            4 => "M&#46; Zeviani"
                            5 => "L&#46; Farina"
                          ]
                        ]
                      ]
                    ]
                  ]
                  "host" => array:1 [
                    0 => array:2 [
                      "doi" => "10.3389/fgene.2014.00412"
                      "Revista" => array:5 [
                        "tituloSerie" => "Front&#46; Genet"
                        "fecha" => "2014"
                        "volumen" => "5"
                        "paginaInicial" => "412"
                        "link" => array:1 [
                          0 => array:2 [
                            "url" => "https://www.ncbi.nlm.nih.gov/pubmed/25477904"
                            "web" => "Medline"
                          ]
                        ]
                      ]
                    ]
                  ]
                ]
              ]
            ]
            5 => array:3 [
              "identificador" => "bib0030"
              "etiqueta" => "6"
              "referencia" => array:1 [
                0 => array:2 [
                  "contribucion" => array:1 [
                    0 => array:2 [
                      "titulo" => "Leukoencephalopathy with cysts and hyperglycinemia may result from NFU1deficiency"
                      "autores" => array:1 [
                        0 => array:2 [
                          "etal" => true
                          "autores" => array:6 [
                            0 => "M&#46; Nizon"
                            1 => "A&#46; Boutron"
                            2 => "N&#46; Boddaert"
                            3 => "A&#46; Slama"
                            4 => "H&#46; Delpech"
                            5 => "C&#46; Sardet"
                          ]
                        ]
                      ]
                    ]
                  ]
                  "host" => array:1 [
                    0 => array:2 [
                      "doi" => "10.1016/j.mito.2014.01.003"
                      "Revista" => array:6 [
                        "tituloSerie" => "Mitochondrion"
                        "fecha" => "2014"
                        "volumen" => "15"
                        "paginaInicial" => "59"
                        "paginaFinal" => "64"
                        "link" => array:1 [
                          0 => array:2 [
                            "url" => "https://www.ncbi.nlm.nih.gov/pubmed/24462778"
                            "web" => "Medline"
                          ]
                        ]
                      ]
                    ]
                  ]
                ]
              ]
            ]
            6 => array:3 [
              "identificador" => "bib0035"
              "etiqueta" => "7"
              "referencia" => array:1 [
                0 => array:2 [
                  "contribucion" => array:1 [
                    0 => array:2 [
                      "titulo" => "Guidelines on the diagnosis and treatment of pulmonary hypertension&#58; summary of recommendations"
                      "autores" => array:1 [
                        0 => array:2 [
                          "etal" => true
                          "autores" => array:6 [
                            0 => "J&#46;A&#46; Barber&#224;"
                            1 => "A&#46; Rom&#225;n"
                            2 => "M&#46;A&#46; G&#243;mez-S&#225;nchez"
                            3 => "I&#46; Blanco"
                            4 => "R&#46; Otero"
                            5 => "R&#46; L&#243;pez-Reyes"
                          ]
                        ]
                      ]
                    ]
                  ]
                  "host" => array:1 [
                    0 => array:2 [
                      "doi" => "10.1016/j.arbres.2017.11.014"
                      "Revista" => array:6 [
                        "tituloSerie" => "Arch Bronconeumol"
                        "fecha" => "2018"
                        "volumen" => "54"
                        "paginaInicial" => "205"
                        "paginaFinal" => "215"
                        "link" => array:1 [
                          0 => array:2 [
                            "url" => "https://www.ncbi.nlm.nih.gov/pubmed/29472044"
                            "web" => "Medline"
                          ]
                        ]
                      ]
                    ]
                  ]
                ]
              ]
            ]
            7 => array:3 [
              "identificador" => "bib0040"
              "etiqueta" => "8"
              "referencia" => array:1 [
                0 => array:2 [
                  "contribucion" => array:1 [
                    0 => array:2 [
                      "titulo" => "Protein expression profiles in patients carrying NFU1 mutations&#46; Contribution to the pathophysiology of the disease"
                      "autores" => array:1 [
                        0 => array:2 [
                          "etal" => false
                          "autores" => array:6 [
                            0 => "X&#46; Ferrer-Cort&#233;s"
                            1 => "A&#46; Font"
                            2 => "N&#46; Bujan"
                            3 => "A&#46; Navarro-Sastre"
                            4 => "L&#46; Matalonga"
                            5 => "J&#46;A&#46; Arranz"
                          ]
                        ]
                      ]
                    ]
                  ]
                  "host" => array:1 [
                    0 => array:2 [
                      "doi" => "10.1007/s10545-012-9565-z"
                      "Revista" => array:6 [
                        "tituloSerie" => "J Inherit Metab Dis"
                        "fecha" => "2013"
                        "volumen" => "36"
                        "paginaInicial" => "841"
                        "paginaFinal" => "847"
                        "link" => array:1 [
                          0 => array:2 [
                            "url" => "https://www.ncbi.nlm.nih.gov/pubmed/23179554"
                            "web" => "Medline"
                          ]
                        ]
                      ]
                    ]
                  ]
                ]
              ]
            ]
            8 => array:3 [
              "identificador" => "bib0045"
              "etiqueta" => "9"
              "referencia" => array:1 [
                0 => array:2 [
                  "contribucion" => array:1 [
                    0 => array:2 [
                      "titulo" => "Impact of mutations within the &#91;Fe-S&#93; cluster or the lipoic acid biosynthesis pathways on mitochondrial protein expression profiles in fibroblasts from patients"
                      "autores" => array:1 [
                        0 => array:2 [
                          "etal" => false
                          "autores" => array:6 [
                            0 => "E&#46; Lebigot"
                            1 => "P&#46; Gaignard"
                            2 => "I&#46; Dorboz"
                            3 => "A&#46; Slama"
                            4 => "M&#46; Rio"
                            5 => "P&#46; de Lonlay"
                          ]
                        ]
                      ]
                    ]
                  ]
                  "host" => array:1 [
                    0 => array:2 [
                      "doi" => "10.1016/j.ymgme.2017.08.001"
                      "Revista" => array:6 [
                        "tituloSerie" => "Mol Genet Metab"
                        "fecha" => "2017"
                        "volumen" => "122"
                        "paginaInicial" => "85"
                        "paginaFinal" => "94"
                        "link" => array:1 [
                          0 => array:2 [
                            "url" => "https://www.ncbi.nlm.nih.gov/pubmed/28803783"
                            "web" => "Medline"
                          ]
                        ]
                      ]
                    ]
                  ]
                ]
              ]
            ]
            9 => array:3 [
              "identificador" => "bib0050"
              "etiqueta" => "10"
              "referencia" => array:1 [
                0 => array:2 [
                  "contribucion" => array:1 [
                    0 => array:2 [
                      "titulo" => "Understanding the molecular basis of multiple mitochondrial dysfunctions syndrome 1 &#40;MMDS1&#41;&#8212;impact of a disease-causing Gly208Cys substitution on structure and activity of NFU1 in the Fe&#47;S cluster biosynthetic pathway"
                      "autores" => array:1 [
                        0 => array:2 [
                          "etal" => false
                          "autores" => array:4 [
                            0 => "C&#46; Wachnowsky"
                            1 => "N&#46;A&#46; Wesley"
                            2 => "I&#46; Fidai"
                            3 => "J&#46;A&#46; Cowan"
                          ]
                        ]
                      ]
                    ]
                  ]
                  "host" => array:1 [
                    0 => array:2 [
                      "doi" => "10.1016/j.jmb.2017.01.021"
                      "Revista" => array:6 [
                        "tituloSerie" => "J Mol Biol"
                        "fecha" => "2017"
                        "volumen" => "429"
                        "paginaInicial" => "790"
                        "paginaFinal" => "807"
                        "link" => array:1 [
                          0 => array:2 [
                            "url" => "https://www.ncbi.nlm.nih.gov/pubmed/28161430"
                            "web" => "Medline"
                          ]
                        ]
                      ]
                    ]
                  ]
                ]
              ]
            ]
            10 => array:3 [
              "identificador" => "bib0055"
              "etiqueta" => "11"
              "referencia" => array:1 [
                0 => array:2 [
                  "contribucion" => array:1 [
                    0 => array:2 [
                      "titulo" => "NFU1-related disorders as key differential diagnosis of cavitating leukoencephalopathy"
                      "autores" => array:1 [
                        0 => array:2 [
                          "etal" => false
                          "autores" => array:6 [
                            0 => "P&#46;V&#46;S&#46; De Souza"
                            1 => "T&#46; Bortholin"
                            2 => "S&#46; Burlin"
                            3 => "F&#46;G&#46;M&#46; Naylor"
                            4 => "W&#46;B&#46;V&#46;R&#46; Pinto"
                            5 => "A&#46;S&#46;B&#46; Oliveira"
                          ]
                        ]
                      ]
                    ]
                  ]
                  "host" => array:1 [
                    0 => array:2 [
                      "doi" => "10.1055/s-0037-1606295"
                      "Revista" => array:6 [
                        "tituloSerie" => "J Pediatr Genet"
                        "fecha" => "2018"
                        "volumen" => "7"
                        "paginaInicial" => "40"
                        "paginaFinal" => "42"
                        "link" => array:1 [
                          0 => array:2 [
                            "url" => "https://www.ncbi.nlm.nih.gov/pubmed/29441221"
                            "web" => "Medline"
                          ]
                        ]
                      ]
                    ]
                  ]
                ]
              ]
            ]
          ]
        ]
      ]
    ]
  ]
  "idiomaDefecto" => "en"
  "url" => "/15792129/0000005600000012/v1_202012151701/S1579212920302834/v1_202012151701/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/15792129/0000005600000012/v1_202012151701/S1579212920302834/v1_202012151701/en/main.pdf?idApp=UINPBA00003Z&text.app=https://archbronconeumol.org/"
  "EPUB" => "https://multimedia.elsevier.es/PublicationsMultimediaV1/item/epub/S1579212920302834?idApp=UINPBA00003Z"
]
Share
Journal Information

Statistics

Follow this link to access the full text of the article

Scientific Letter
Severe Pulmonary Hypertension as the Debut of Metabolic Disease
Hipertensión pulmonar grave como inicio de la enfermedad metabólica
Lorena Estepa Pedregosaa, Carmina Guitart Pardellansb,
Corresponding author
, Benjamin Jaume Baucells Lokyerc, Fredy Hermógenes Prada Martínezd, Àngels García Cazorlae,f, Francisco José Cambra Lasaosab, Susana Segura Matuteb
a Unidad de Cuidados Intensivos Pediátricos (UCIP), Hospital Universitario Puerta del Mar, Cádiz, Spain
b Unidad de Cuidados Intensivos Pediátricos (UCIP), Hospital Sant Joan de Déu. Institut de Recerca H. Sant Joan de Déu, Barcelona, Spain
c Servicio de Pediatría, Hospital Sant Joan de Déu. Institut de Recerca H. Sant Joan de Déu, Barcelona, Spain
d Departamento de Cardiología, Hospital Sant Joan de Déu. Institut de Recerca H. Sant Joan de Déu, Barcelona, Spain
e Departamento de Genética y Medicina Molecular, Hospital Sant Joan de Déu y CIBERER, Barcelona, Spain
f Departamento de Neurología, Unidad de Enfermedades Neurometabólicas, Hospital Sant Joan de Déu and CIBERER, Barcelona, Spain
Read
1790
Times
was read the article
711
Total PDF
1079
Total HTML
Share statistics
 array:24 [
  "pii" => "S1579212920302834"
  "issn" => "15792129"
  "doi" => "10.1016/j.arbr.2020.06.009"
  "estado" => "S300"
  "fechaPublicacion" => "2020-12-01"
  "aid" => "2551"
  "copyright" => "SEPAR"
  "copyrightAnyo" => "2020"
  "documento" => "simple-article"
  "crossmark" => 1
  "subdocumento" => "crp"
  "cita" => "Arch Bronconeumol. 2020;56:820-1"
  "abierto" => array:3 [
    "ES" => false
    "ES2" => false
    "LATM" => false
  ]
  "gratuito" => false
  "lecturas" => array:1 [
    "total" => 0
  ]
  "Traduccion" => array:1 [
    "es" => array:19 [
      "pii" => "S0300289620302246"
      "issn" => "03002896"
      "doi" => "10.1016/j.arbres.2020.06.020"
      "estado" => "S300"
      "fechaPublicacion" => "2020-12-01"
      "aid" => "2551"
      "copyright" => "SEPAR"
      "documento" => "simple-article"
      "crossmark" => 1
      "subdocumento" => "crp"
      "cita" => "Arch Bronconeumol. 2020;56:820-1"
      "abierto" => array:3 [
        "ES" => true
        "ES2" => true
        "LATM" => true
      ]
      "gratuito" => true
      "lecturas" => array:1 [
        "total" => 0
      ]
      "es" => array:11 [
        "idiomaDefecto" => true
        "cabecera" => "<span class="elsevierStyleTextfn">Carta Cient&#237;fica</span>"
        "titulo" => "Hipertensi&#243;n pulmonar grave como inicio de la enfermedad metab&#243;lica"
        "tienePdf" => "es"
        "tieneTextoCompleto" => "es"
        "paginas" => array:1 [
          0 => array:2 [
            "paginaInicial" => "820"
            "paginaFinal" => "821"
          ]
        ]
        "titulosAlternativos" => array:1 [
          "en" => array:1 [
            "titulo" => "Severe Pulmonary Hypertension as the Debut of Metabolic Disease"
          ]
        ]
        "contieneTextoCompleto" => array:1 [
          "es" => true
        ]
        "contienePdf" => array:1 [
          "es" => true
        ]
        "resumenGrafico" => array:2 [
          "original" => 0
          "multimedia" => array:7 [
            "identificador" => "fig0010"
            "etiqueta" => "Figura 2"
            "tipo" => "MULTIMEDIAFIGURA"
            "mostrarFloat" => true
            "mostrarDisplay" => false
            "figura" => array:1 [
              0 => array:4 [
                "imagen" => "gr2.jpeg"
                "Alto" => 2606
                "Ancho" => 6096
                "Tamanyo" => 316964
              ]
            ]
            "descripcion" => array:1 [
              "es" => "<p id="spar0010" class="elsevierStyleSimplePara elsevierViewall">Izquierda&#58; Resonancia magn&#233;tica &#40;RM&#41; cerebral&#46; Secuencia de difusi&#243;n&#44; corte axial&#46; Se aprecia hiperse&#241;al difusa de la sustancia blanca&#46; Derecha&#58; Espectroscopia de RM cerebral&#46; Pico de glicina en sustancia blanca parietal derecha&#46;</p>"
            ]
          ]
        ]
        "autores" => array:1 [
          0 => array:2 [
            "autoresLista" => "Lorena Estepa Pedregosa, Carmina Guitart Pardellans, Benjamin Jaume Baucells Lokyer, Fredy Herm&#243;genes Prada Mart&#237;nez, &#192;ngels Garc&#237;a Cazorla, Francisco Jos&#233; Cambra Lasaosa, Susana Segura Matute"
            "autores" => array:7 [
              0 => array:2 [
                "nombre" => "Lorena"
                "apellidos" => "Estepa Pedregosa"
              ]
              1 => array:2 [
                "nombre" => "Carmina"
                "apellidos" => "Guitart Pardellans"
              ]
              2 => array:2 [
                "nombre" => "Benjamin Jaume"
                "apellidos" => "Baucells Lokyer"
              ]
              3 => array:2 [
                "nombre" => "Fredy Herm&#243;genes"
                "apellidos" => "Prada Mart&#237;nez"
              ]
              4 => array:2 [
                "nombre" => "&#192;ngels"
                "apellidos" => "Garc&#237;a Cazorla"
              ]
              5 => array:2 [
                "nombre" => "Francisco Jos&#233;"
                "apellidos" => "Cambra Lasaosa"
              ]
              6 => array:2 [
                "nombre" => "Susana"
                "apellidos" => "Segura Matute"
              ]
            ]
          ]
        ]
      ]
      "idiomaDefecto" => "es"
      "Traduccion" => array:1 [
        "en" => array:9 [
          "pii" => "S1579212920302834"
          "doi" => "10.1016/j.arbr.2020.06.009"
          "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/S1579212920302834?idApp=UINPBA00003Z"
        ]
      ]
      "EPUB" => "https://multimedia.elsevier.es/PublicationsMultimediaV1/item/epub/S0300289620302246?idApp=UINPBA00003Z"
      "url" => "/03002896/0000005600000012/v1_202012050807/S0300289620302246/v1_202012050807/es/main.assets"
    ]
  ]
  "itemSiguiente" => array:18 [
    "pii" => "S157921292030344X"
    "issn" => "15792129"
    "doi" => "10.1016/j.arbr.2020.06.014"
    "estado" => "S300"
    "fechaPublicacion" => "2020-12-01"
    "aid" => "2552"
    "copyright" => "SEPAR"
    "documento" => "simple-article"
    "crossmark" => 1
    "subdocumento" => "crp"
    "cita" => "Arch Bronconeumol. 2020;56:822-3"
    "abierto" => array:3 [
      "ES" => false
      "ES2" => false
      "LATM" => false
    ]
    "gratuito" => false
    "lecturas" => array:1 [
      "total" => 0
    ]
    "en" => array:11 [
      "idiomaDefecto" => true
      "cabecera" => "<span class="elsevierStyleTextfn">Scientific Letter</span>"
      "titulo" => "Osimertinib for the Treatment of EGFR Mutation-Positive Lung Adenocarcinoma Complicated With Dermatomyositis"
      "tienePdf" => "en"
      "tieneTextoCompleto" => "en"
      "paginas" => array:1 [
        0 => array:2 [
          "paginaInicial" => "822"
          "paginaFinal" => "823"
        ]
      ]
      "titulosAlternativos" => array:1 [
        "es" => array:1 [
          "titulo" => "El osimertinib como tratamiento del adenocarcinoma de pulm&#243;n con mutaci&#243;n positiva del EGFR complicado con dermatomiositis"
        ]
      ]
      "contieneTextoCompleto" => array:1 [
        "en" => true
      ]
      "contienePdf" => array:1 [
        "en" => true
      ]
      "resumenGrafico" => array:2 [
        "original" => 0
        "multimedia" => array:7 [
          "identificador" => "fig0005"
          "etiqueta" => "Fig&#46; 1"
          "tipo" => "MULTIMEDIAFIGURA"
          "mostrarFloat" => true
          "mostrarDisplay" => false
          "figura" => array:1 [
            0 => array:4 [
              "imagen" => "gr1.jpeg"
              "Alto" => 881
              "Ancho" => 1600
              "Tamanyo" => 212565
            ]
          ]
          "descripcion" => array:1 [
            "en" => "<p id="spar0005" class="elsevierStyleSimplePara elsevierViewall">&#40;A&#44; B&#41; Dermatological findings after the first examination of the patient&#46; &#40;A&#41; Visible erythema over both eyelids &#40;heliotrope rash&#41; with facial edema&#46; &#40;B&#41; Papules &#40;Gottron&#39;s papules&#41; and edema on the dorsal surface of the hands are visible&#46; &#40;C&#41; Chest computed tomography &#40;CT&#41; scan showing primary lesion in the right lung&#44; lower lobe &#40;arrow&#41;&#46; &#40;D&#41; Chest CT scan showing mediastinal lymphadenopathy&#46;</p>"
          ]
        ]
      ]
      "autores" => array:1 [
        0 => array:2 [
          "autoresLista" => "Masahiro Yamasaki, Naoko Matsumoto, Shota Nakano, Kazuma Kawamoto, Masaya Taniwaki, Yusuke Izumi, Masaya Otohara, Shinji Nabeshima, Nobuyuki Ohashi, Noboru Hattori"
          "autores" => array:10 [
            0 => array:2 [
              "nombre" => "Masahiro"
              "apellidos" => "Yamasaki"
            ]
            1 => array:2 [
              "nombre" => "Naoko"
              "apellidos" => "Matsumoto"
            ]
            2 => array:2 [
              "nombre" => "Shota"
              "apellidos" => "Nakano"
            ]
            3 => array:2 [
              "nombre" => "Kazuma"
              "apellidos" => "Kawamoto"
            ]
            4 => array:2 [
              "nombre" => "Masaya"
              "apellidos" => "Taniwaki"
            ]
            5 => array:2 [
              "nombre" => "Yusuke"
              "apellidos" => "Izumi"
            ]
            6 => array:2 [
              "nombre" => "Masaya"
              "apellidos" => "Otohara"
            ]
            7 => array:2 [
              "nombre" => "Shinji"
              "apellidos" => "Nabeshima"
            ]
            8 => array:2 [
              "nombre" => "Nobuyuki"
              "apellidos" => "Ohashi"
            ]
            9 => array:2 [
              "nombre" => "Noboru"
              "apellidos" => "Hattori"
            ]
          ]
        ]
      ]
    ]
    "idiomaDefecto" => "en"
    "EPUB" => "https://multimedia.elsevier.es/PublicationsMultimediaV1/item/epub/S157921292030344X?idApp=UINPBA00003Z"
    "url" => "/15792129/0000005600000012/v1_202012151701/S157921292030344X/v1_202012151701/en/main.assets"
  ]
  "itemAnterior" => array:19 [
    "pii" => "S1579212920302822"
    "issn" => "15792129"
    "doi" => "10.1016/j.arbr.2020.06.008"
    "estado" => "S300"
    "fechaPublicacion" => "2020-12-01"
    "aid" => "2549"
    "copyright" => "SEPAR"
    "documento" => "article"
    "crossmark" => 1
    "subdocumento" => "crp"
    "cita" => "Arch Bronconeumol. 2020;56:818-9"
    "abierto" => array:3 [
      "ES" => false
      "ES2" => false
      "LATM" => false
    ]
    "gratuito" => false
    "lecturas" => array:1 [
      "total" => 0
    ]
    "en" => array:10 [
      "idiomaDefecto" => true
      "cabecera" => "<span class="elsevierStyleTextfn">Scientific Letter</span>"
      "titulo" => "Study of adherence to continuous positive airway pressure treatment in patients with obstructive sleep apnea syndrome in the confinement during the COVID-19 pandemic"
      "tienePdf" => "en"
      "tieneTextoCompleto" => "en"
      "paginas" => array:1 [
        0 => array:2 [
          "paginaInicial" => "818"
          "paginaFinal" => "819"
        ]
      ]
      "titulosAlternativos" => array:1 [
        "es" => array:1 [
          "titulo" => "Estudio de la adherencia al tratamiento con presi&#243;n continua positiva en la v&#237;a a&#233;rea en pacientes con s&#237;ndrome de apnea obstructiva del sue&#241;o en el confinamiento impuesto durante la pandemia de COVID-19"
        ]
      ]
      "contieneTextoCompleto" => array:1 [
        "en" => true
      ]
      "contienePdf" => array:1 [
        "en" => true
      ]
      "autores" => array:1 [
        0 => array:2 [
          "autoresLista" => "F&#233;lix del Campo, Graciela L&#243;pez, C&#46; Ainhoa Arroyo, Julio F&#46; de Frutos, Andrea Crespo, Ana Cerezo-Hern&#225;ndez, Tania M&#46; &#193;lvaro, Tom&#225;s Ruiz, Fernando Moreno, Gonzalo C&#46; Guti&#233;rrez-Tobal, Roberto Hornero, Daniel &#193;lvarez"
          "autores" => array:12 [
            0 => array:2 [
              "nombre" => "F&#233;lix"
              "apellidos" => "del Campo"
            ]
            1 => array:2 [
              "nombre" => "Graciela"
              "apellidos" => "L&#243;pez"
            ]
            2 => array:2 [
              "nombre" => "C&#46; Ainhoa"
              "apellidos" => "Arroyo"
            ]
            3 => array:2 [
              "nombre" => "Julio F&#46;"
              "apellidos" => "de Frutos"
            ]
            4 => array:2 [
              "nombre" => "Andrea"
              "apellidos" => "Crespo"
            ]
            5 => array:2 [
              "nombre" => "Ana"
              "apellidos" => "Cerezo-Hern&#225;ndez"
            ]
            6 => array:2 [
              "nombre" => "Tania M&#46;"
              "apellidos" => "&#193;lvaro"
            ]
            7 => array:2 [
              "nombre" => "Tom&#225;s"
              "apellidos" => "Ruiz"
            ]
            8 => array:2 [
              "nombre" => "Fernando"
              "apellidos" => "Moreno"
            ]
            9 => array:2 [
              "nombre" => "Gonzalo C&#46;"
              "apellidos" => "Guti&#233;rrez-Tobal"
            ]
            10 => array:2 [
              "nombre" => "Roberto"
              "apellidos" => "Hornero"
            ]
            11 => array:2 [
              "nombre" => "Daniel"
              "apellidos" => "&#193;lvarez"
            ]
          ]
        ]
      ]
    ]
    "idiomaDefecto" => "en"
    "Traduccion" => array:1 [
      "es" => array:9 [
        "pii" => "S0300289620302222"
        "doi" => "10.1016/j.arbres.2020.06.019"
        "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/S0300289620302222?idApp=UINPBA00003Z"
      ]
    ]
    "EPUB" => "https://multimedia.elsevier.es/PublicationsMultimediaV1/item/epub/S1579212920302822?idApp=UINPBA00003Z"
    "url" => "/15792129/0000005600000012/v1_202012151701/S1579212920302822/v1_202012151701/en/main.assets"
  ]
  "en" => array:17 [
    "idiomaDefecto" => true
    "cabecera" => "<span class="elsevierStyleTextfn">Scientific Letter</span>"
    "titulo" => "Severe Pulmonary Hypertension as the Debut of Metabolic Disease"
    "tieneTextoCompleto" => true
    "saludo" => "To the Editor&#44;"
    "paginas" => array:1 [
      0 => array:2 [
        "paginaInicial" => "820"
        "paginaFinal" => "821"
      ]
    ]
    "autores" => array:1 [
      0 => array:4 [
        "autoresLista" => "Lorena Estepa Pedregosa, Carmina Guitart Pardellans, Benjamin Jaume Baucells Lokyer, Fredy Herm&#243;genes Prada Mart&#237;nez, &#192;ngels Garc&#237;a Cazorla, Francisco Jos&#233; Cambra Lasaosa, Susana Segura Matute"
        "autores" => array:7 [
          0 => array:3 [
            "nombre" => "Lorena"
            "apellidos" => "Estepa Pedregosa"
            "referencia" => array:1 [
              0 => array:2 [
                "etiqueta" => "<span class="elsevierStyleSup">a</span>"
                "identificador" => "aff0005"
              ]
            ]
          ]
          1 => array:4 [
            "nombre" => "Carmina"
            "apellidos" => "Guitart Pardellans"
            "email" => array:1 [
              0 => "cguitart@sjdhospitalbarcelona.org"
            ]
            "referencia" => array:2 [
              0 => array:2 [
                "etiqueta" => "<span class="elsevierStyleSup">b</span>"
                "identificador" => "aff0010"
              ]
              1 => array:2 [
                "etiqueta" => "&#42;"
                "identificador" => "cor0005"
              ]
            ]
          ]
          2 => array:3 [
            "nombre" => "Benjamin Jaume"
            "apellidos" => "Baucells Lokyer"
            "referencia" => array:1 [
              0 => array:2 [
                "etiqueta" => "<span class="elsevierStyleSup">c</span>"
                "identificador" => "aff0015"
              ]
            ]
          ]
          3 => array:3 [
            "nombre" => "Fredy Herm&#243;genes"
            "apellidos" => "Prada Mart&#237;nez"
            "referencia" => array:1 [
              0 => array:2 [
                "etiqueta" => "<span class="elsevierStyleSup">d</span>"
                "identificador" => "aff0020"
              ]
            ]
          ]
          4 => array:3 [
            "nombre" => "&#192;ngels"
            "apellidos" => "Garc&#237;a Cazorla"
            "referencia" => array:2 [
              0 => array:2 [
                "etiqueta" => "<span class="elsevierStyleSup">e</span>"
                "identificador" => "aff0025"
              ]
              1 => array:2 [
                "etiqueta" => "<span class="elsevierStyleSup">f</span>"
                "identificador" => "aff0030"
              ]
            ]
          ]
          5 => array:3 [
            "nombre" => "Francisco Jos&#233;"
            "apellidos" => "Cambra Lasaosa"
            "referencia" => array:1 [
              0 => array:2 [
                "etiqueta" => "<span class="elsevierStyleSup">b</span>"
                "identificador" => "aff0010"
              ]
            ]
          ]
          6 => array:3 [
            "nombre" => "Susana"
            "apellidos" => "Segura Matute"
            "referencia" => array:1 [
              0 => array:2 [
                "etiqueta" => "<span class="elsevierStyleSup">b</span>"
                "identificador" => "aff0010"
              ]
            ]
          ]
        ]
        "afiliaciones" => array:6 [
          0 => array:3 [
            "entidad" => "Unidad de Cuidados Intensivos Pedi&#225;tricos &#40;UCIP&#41;&#44; Hospital Universitario Puerta del Mar&#44; C&#225;diz&#44; Spain"
            "etiqueta" => "a"
            "identificador" => "aff0005"
          ]
          1 => array:3 [
            "entidad" => "Unidad de Cuidados Intensivos Pedi&#225;tricos &#40;UCIP&#41;&#44; Hospital Sant Joan de D&#233;u&#46; Institut de Recerca H&#46; Sant Joan de D&#233;u&#44; Barcelona&#44; Spain"
            "etiqueta" => "b"
            "identificador" => "aff0010"
          ]
          2 => array:3 [
            "entidad" => "Servicio de Pediatr&#237;a&#44; Hospital Sant Joan de D&#233;u&#46; Institut de Recerca H&#46; Sant Joan de D&#233;u&#44; Barcelona&#44; Spain"
            "etiqueta" => "c"
            "identificador" => "aff0015"
          ]
          3 => array:3 [
            "entidad" => "Departamento de Cardiolog&#237;a&#44; Hospital Sant Joan de D&#233;u&#46; Institut de Recerca H&#46; Sant Joan de D&#233;u&#44; Barcelona&#44; Spain"
            "etiqueta" => "d"
            "identificador" => "aff0020"
          ]
          4 => array:3 [
            "entidad" => "Departamento de Gen&#233;tica y Medicina Molecular&#44; Hospital Sant Joan de D&#233;u y CIBERER&#44; Barcelona&#44; Spain"
            "etiqueta" => "e"
            "identificador" => "aff0025"
          ]
          5 => array:3 [
            "entidad" => "Departamento de Neurolog&#237;a&#44; Unidad de Enfermedades Neurometab&#243;licas&#44; Hospital Sant Joan de D&#233;u and CIBERER&#44; Barcelona&#44; Spain"
            "etiqueta" => "f"
            "identificador" => "aff0030"
          ]
        ]
        "correspondencia" => array:1 [
          0 => array:3 [
            "identificador" => "cor0005"
            "etiqueta" => "&#8270;"
            "correspondencia" => "Corresponding author&#46;"
          ]
        ]
      ]
    ]
    "titulosAlternativos" => array:1 [
      "es" => array:1 [
        "titulo" => "Hipertensi&#243;n pulmonar grave como inicio de la enfermedad metab&#243;lica"
      ]
    ]
    "resumenGrafico" => array:2 [
      "original" => 0
      "multimedia" => array:8 [
        "identificador" => "fig0010"
        "etiqueta" => "Fig&#46; 2"
        "tipo" => "MULTIMEDIAFIGURA"
        "mostrarFloat" => true
        "mostrarDisplay" => false
        "figura" => array:1 [
          0 => array:4 [
            "imagen" => "gr2.jpeg"
            "Alto" => 2606
            "Ancho" => 6096
            "Tamanyo" => 316964
          ]
        ]
        "detalles" => array:1 [
          0 => array:3 [
            "identificador" => "at0010"
            "detalle" => "Fig&#46; "
            "rol" => "short"
          ]
        ]
        "descripcion" => array:1 [
          "en" => "<p id="spar0010" class="elsevierStyleSimplePara elsevierViewall">Left&#58; Brain magnetic resonance imaging &#40;MRI&#41;&#46; Diffusion sequence&#44; axial slice&#46; Diffuse hypersignal in white matter&#46; Right&#58; Brain MR spectroscopy&#46; Glycine peak in right parietal white substance&#46;</p>"
        ]
      ]
    ]
    "textoCompleto" => "<span class="elsevierStyleSections"><p id="par0005" class="elsevierStylePara elsevierViewall">We report the case of a 6-month-old boy with severe pulmonary hypertension &#40;PHT&#41; who presented clinical worsening with acute pulmonary edema &#40;APE&#41; after starting conventional vasodilator treatment&#46; He was referred from another center for a second opinion and to complete the PHT study&#46; Parental consent was obtained for the publication of this case report and images&#46;</p><p id="par0010" class="elsevierStylePara elsevierViewall">The patient was monitored during gestation&#44; and had negative serologies and normal ultrasound scans&#46; He was delivered at term with an appropriate weight for his gestational age and no perinatal incidents&#46; Family history was significant for a spontaneous abortion and 2 healthy living siblings from the mother&#46; At 3 months of age&#44; he began to develop difficulty with ingestion&#44; growth impairment&#44; and hypotonia with mild psychomotor retardation&#46;</p><p id="par0015" class="elsevierStylePara elsevierViewall">He was admitted to the ward and received oxygen therapy&#44; oral sildenafil&#44; and inhaled prostacyclins&#46; After 5 days&#44; his situation suddenly worsened with desaturation and low cardiac output&#44; so he was transferred to the pediatric ICU&#46; Mechanical ventilation began with a FiO<span class="elsevierStyleInf">2</span> of 1&#44; nitric oxide up to 20&#8239;ppm&#44; and inotropic support with dopamine&#46; X-ray revealed Kerley B-lines and mottled perihilar infiltrates&#44; while thoracic ultrasound showed homogeneous increase in B-lines&#44; with no condensations or pleural effusion&#46; Echocardiography showed signs of severe PHT &#40;<a class="elsevierStyleCrossRef" href="#fig0005">Fig&#46; 1</a>&#41; with an estimated pulmonary artery pressure &#40;PAP&#41; of 70&#8239;mmHg &#40;normal value &#91;NV&#93;&#8239;&#60;&#8239;20&#8239;mmHg&#41;&#46; Cardiac catheterization was performed which showed&#58; systolic PAP&#47;diastolic &#40;mean&#41; PAP of 53&#47;24 &#40;38&#41; mmHg &#40;NV systolic PAP&#8239;&#60;&#8239;35&#8239;mmHg&#44; mean PAP&#8239;&#60;&#8239;20&#8239;mmHg&#41;&#44;<a class="elsevierStyleCrossRef" href="#bib0005"><span class="elsevierStyleSup">1</span></a> pulmonary resistances of 8&#46;51 Wood units&#47;m<span class="elsevierStyleSup">2</span> &#40;NV&#8239;&#60;&#8239;3&#8239;WU&#47;m<span class="elsevierStyleSup">2</span>&#41;&#44; and pulmonary artery wedge pressure &#40;PWP&#41; of 10&#8239;mmHg &#40;NV&#8239;&#60;&#8239;15&#8239;mmHg&#41;&#46;<a class="elsevierStyleCrossRef" href="#bib0005"><span class="elsevierStyleSup">1</span></a> Left heart changes were thus excluded as the cause of PHT&#46;</p><elsevierMultimedia ident="fig0005"></elsevierMultimedia><p id="par0020" class="elsevierStylePara elsevierViewall">The metabolic study was expanded&#44; showing hyperlactacidemia with 8&#46;1&#8239;mmol&#47;L lactate &#40;NV&#8239;&#60;&#8239;2&#8239;mmol&#47;L&#41; and no metabolic acidosis or ketosis&#44; increased blood glycine of 1&#44;599&#8239;&#181;mol&#47;L &#40;NV 109-293&#8239;&#956;mol&#47;L&#41;&#44; and 83&#46;1&#8239;&#956;mol cerebrospinal fluid &#40;CSF&#41; &#40;NV 3-13&#8239;&#956;mol&#41;&#46; Non-ketotic hyperglycinemia &#40;NKHG&#41; was suspected&#44; and treatment began with thiamine&#44; sodium benzoate&#44; lipoic acid and acetyl cysteine&#44; and brain magnetic resonance imaging &#40;MRI&#41; was performed &#40;<a class="elsevierStyleCrossRef" href="#fig0010">Fig&#46; 2</a>&#41;&#44; revealing reduced subcortical deep white matter&#44; while altered myelination with glycine peak in the right parietal white substance was observed on spectroscopy &#40;<a class="elsevierStyleCrossRef" href="#fig0010">Fig&#46; 2</a>&#41;&#46;</p><elsevierMultimedia ident="fig0010"></elsevierMultimedia><p id="par0025" class="elsevierStylePara elsevierViewall">Despite all efforts&#44; the patient&#8217;s severe PHT persisted and he died 28 days after admission&#46; The result of the genetic study was received 2 weeks later&#44; confirming mutation in the NFU1 gene &#40;c&#46;565&#8239;G&#8239;&#62;&#8239;A&#44; p&#46;Gly189Arg&#41;&#44; described in the literature as pathogenic&#44; causing mitochondrial dysfunction in multiple organs&#46;</p><p id="par0030" class="elsevierStylePara elsevierViewall">PHT is rare in pediatrics and mainly associated with inborn errors of metabolism&#46; Prognosis in these cases is fatal&#46;<a class="elsevierStyleCrossRefs" href="#bib0005"><span class="elsevierStyleSup">1&#44;2</span></a> In all infants with PHT&#44; any association with metabolic disease should be ruled out&#44; as PHT may appear before neurological manifestations&#46;<a class="elsevierStyleCrossRef" href="#bib0015"><span class="elsevierStyleSup">3</span></a> Specifically&#44; if the patient develops associated neurological manifestations&#44; signs of multiorgan failure&#44; or if APE occurs with conventional treatment&#44;<a class="elsevierStyleCrossRefs" href="#bib0010"><span class="elsevierStyleSup">2&#8211;7</span></a> a metabolic study should be performed to check for an increase in glycine levels in plasma&#44; CSF and urine&#44; as was performed in our patient&#46;<a class="elsevierStyleCrossRefs" href="#bib0010"><span class="elsevierStyleSup">2&#44;4&#8211;6</span></a> The combined defect of pyruvate dehydrogenase complex activity and different respiratory chain complexes in skeletal muscle&#44; skin fibroblasts and liver has also been defined&#46;<a class="elsevierStyleCrossRefs" href="#bib0010"><span class="elsevierStyleSup">2&#44;4&#8211;6</span></a></p><p id="par0035" class="elsevierStylePara elsevierViewall">So far&#44; 3 phenotypes associated with either neurological or respiratory symptoms or both have been described&#46;<a class="elsevierStyleCrossRef" href="#bib0010"><span class="elsevierStyleSup">2</span></a> In our case&#44; the patient had PHT with hypotonia and slightly delayed psychomotor development&#44; so he could be included in the third group&#46; As in the cases described in the literature&#44; leukoencephalopathy was observed on MRI and glycine peak was seen in the right parietal lobe&#46;<a class="elsevierStyleCrossRefs" href="#bib0010"><span class="elsevierStyleSup">2&#44;4&#8211;6</span></a></p><p id="par0040" class="elsevierStylePara elsevierViewall">In the series described so far&#44; the onset of PHT occurs in the first 6 months of life&#44; it does not respond to usual treatment&#44; and the prognosis is unfavorable&#44; with the patient dying in the first 15 months of life&#46;<a class="elsevierStyleCrossRefs" href="#bib0010"><span class="elsevierStyleSup">2&#44;4</span></a> In addition&#44; clinical worsening after initiation of vasodilator treatment is described in all cases&#46;</p><p id="par0045" class="elsevierStylePara elsevierViewall">Invernizzi et al&#46; and Nizon et al&#46; published the case of 2 patients who survived longer&#44; dying at 30 months of age&#46;<a class="elsevierStyleCrossRefs" href="#bib0025"><span class="elsevierStyleSup">5&#44;6</span></a> Both cases were associated with the same allelic alteration of the NFU1 gene &#40;c&#46;565G&#8239;&#62;&#8239;A&#44; p&#46;Gly189Arg&#41;&#46; The other patients had different mutations of the NFU1 gene and died earlier&#46;</p><p id="par0050" class="elsevierStylePara elsevierViewall">Our patient&#8217;s genetic study revealed 2 mutations in the NFU1 gene&#46; One had been previously described as pathogenic &#40;P&#46;Gly208Cys&#47;c&#46;622G&#8239;&#62;&#8239;T&#41;&#44;<a class="elsevierStyleCrossRefs" href="#bib0010"><span class="elsevierStyleSup">2&#44;8&#8211;11</span></a> but the second sequenced mutation &#40;P&#46;Trp130Arg&#47;c&#46; 388T&#8239;&#62;&#8239;C&#41; was classified as a variant of uncertain meaning&#46; Since this mutation has not been previously described in a disease with recessive inheritance&#44; it should be considered in future research in case it is a pathogenic mutation&#46; NFU1 gene mutations cause mitochondrial dysfunction in multiple organs with an autosomal recessive pattern of inheritance&#46;</p><p id="par0055" class="elsevierStylePara elsevierViewall">NFU1 gene alterations decrease or eliminate the production of the protein involved in the formation of iron sulfide complexes that bind to certain proteins and are required for their proper function&#44; such as the production of mitochondrial energy and the decomposition of glycine&#46; This phenomenon explains the laboratory and clinical findings of our patient&#46;<a class="elsevierStyleCrossRef" href="#bib0010"><span class="elsevierStyleSup">2</span></a></p><p id="par0060" class="elsevierStylePara elsevierViewall">In conclusion&#44; PHT associated with inborn errors of metabolism is rare and confers a bleak prognosis&#46; It should be suspected in an infant with severe PHT and sometimes neurological symptoms&#44; who presents clinical worsening with PAE after initiation of conventional treatment&#44; and hyperlactacidemia without metabolic acidosis&#46; Therefore&#44; in all cases of idiopathic PHT&#44; metabolic studies should be performed&#46; It is important to reach a diagnosis in order to offer of genetic counseling because this disease is fatal and no curative treatment has been described to date&#46;</p></span>"
    "pdfFichero" => "main.pdf"
    "tienePdf" => true
    "fechaRecibido" => "2020-04-22"
    "fechaAceptado" => "2020-06-22"
    "NotaPie" => array:1 [
      0 => array:2 [
        "etiqueta" => "&#9734;"
        "nota" => "<p class="elsevierStyleNotepara" id="npar0005">Please cite this article as&#58; Estepa Pedregosa L&#44; Guitart Pardellans C&#44; Baucells Lokyer BJ&#44; Prada Mart&#237;nez FH&#44; Garc&#237;a Cazorla A&#44; Cambra Lasaosa FJ&#44; et al&#46; Hipertensi&#243;n pulmonar grave como inicio de la enfermedad metab&#243;lica&#46; Arch Bronconeumol&#46; 2020&#46; <span class="elsevierStyleInterRef" id="intr0005" href="https://doi.org/10.1016/j.arbres.2020.06.020">https&#58;&#47;&#47;doi&#46;org&#47;10&#46;1016&#47;j&#46;arbres&#46;2020&#46;06&#46;020</span></p>"
      ]
    ]
    "multimedia" => array:2 [
      0 => array:8 [
        "identificador" => "fig0005"
        "etiqueta" => "Fig&#46; 1"
        "tipo" => "MULTIMEDIAFIGURA"
        "mostrarFloat" => true
        "mostrarDisplay" => false
        "figura" => array:1 [
          0 => array:4 [
            "imagen" => "gr1.jpeg"
            "Alto" => 1193
            "Ancho" => 1625
            "Tamanyo" => 182453
          ]
        ]
        "detalles" => array:1 [
          0 => array:3 [
            "identificador" => "at0005"
            "detalle" => "Fig&#46; "
            "rol" => "short"
          ]
        ]
        "descripcion" => array:1 [
          "en" => "<p id="spar0005" class="elsevierStyleSimplePara elsevierViewall">Echocardiography&#46; 4-chamber view&#46; Dilated right cavities with interventricular septum deviated to the left&#46; Moderate tricuspid regurgitation with a gradient of 60&#8239;mmHg allowing estimation of a PAP of approximately 70&#8239;mmHg&#46; Interatrial septum with 5&#8239;mm patent foramen ovale&#46; Valves of normal morphology&#46;</p>"
        ]
      ]
      1 => array:8 [
        "identificador" => "fig0010"
        "etiqueta" => "Fig&#46; 2"
        "tipo" => "MULTIMEDIAFIGURA"
        "mostrarFloat" => true
        "mostrarDisplay" => false
        "figura" => array:1 [
          0 => array:4 [
            "imagen" => "gr2.jpeg"
            "Alto" => 2606
            "Ancho" => 6096
            "Tamanyo" => 316964
          ]
        ]
        "detalles" => array:1 [
          0 => array:3 [
            "identificador" => "at0010"
            "detalle" => "Fig&#46; "
            "rol" => "short"
          ]
        ]
        "descripcion" => array:1 [
          "en" => "<p id="spar0010" class="elsevierStyleSimplePara elsevierViewall">Left&#58; Brain magnetic resonance imaging &#40;MRI&#41;&#46; Diffusion sequence&#44; axial slice&#46; Diffuse hypersignal in white matter&#46; Right&#58; Brain MR spectroscopy&#46; Glycine peak in right parietal white substance&#46;</p>"
        ]
      ]
    ]
    "bibliografia" => array:2 [
      "titulo" => "References"
      "seccion" => array:1 [
        0 => array:2 [
          "identificador" => "bibs0005"
          "bibliografiaReferencia" => array:11 [
            0 => array:3 [
              "identificador" => "bib0005"
              "etiqueta" => "1"
              "referencia" => array:1 [
                0 => array:2 [
                  "contribucion" => array:1 [
                    0 => array:2 [
                      "titulo" => "Assessing pulmonary hypertensive vascular disease in childhood data from the Spanish Registry"
                      "autores" => array:1 [
                        0 => array:2 [
                          "etal" => true
                          "autores" => array:6 [
                            0 => "M&#46;J&#46; Del Cerro Mar&#237;n"
                            1 => "A&#46; Sabat&#233; Rot&#233;s"
                            2 => "A&#46; Rodriguez Orgando"
                            3 => "A&#46; Mendoza Soto"
                            4 => "M&#46; Quero Jim&#233;nez"
                            5 => "J&#46;L&#46; Gavil&#225;n Camacho"
                          ]
                        ]
                      ]
                    ]
                  ]
                  "host" => array:1 [
                    0 => array:2 [
                      "doi" => "10.1164/rccm.201406-1052OC"
                      "Revista" => array:6 [
                        "tituloSerie" => "Am J Respir Crit Care Med"
                        "fecha" => "2014"
                        "volumen" => "190"
                        "paginaInicial" => "1421"
                        "paginaFinal" => "1429"
                        "link" => array:1 [
                          0 => array:2 [
                            "url" => "https://www.ncbi.nlm.nih.gov/pubmed/25379685"
                            "web" => "Medline"
                          ]
                        ]
                      ]
                    ]
                  ]
                ]
              ]
            ]
            1 => array:3 [
              "identificador" => "bib0010"
              "etiqueta" => "2"
              "referencia" => array:1 [
                0 => array:2 [
                  "contribucion" => array:1 [
                    0 => array:2 [
                      "titulo" => "A fatal mitochondrial disease is associated with defective NFU1 function in the maturation of a subset of mitochondrial Fe&#8211;S proteins"
                      "autores" => array:1 [
                        0 => array:2 [
                          "etal" => true
                          "autores" => array:6 [
                            0 => "A&#46; Navarro-Sastre"
                            1 => "F&#46; Tort"
                            2 => "O&#46; Stehling"
                            3 => "M&#46;A&#46; Uzarska"
                            4 => "J&#46;A&#46; Arranz"
                            5 => "M&#46; Del Toro"
                          ]
                        ]
                      ]
                    ]
                  ]
                  "host" => array:1 [
                    0 => array:2 [
                      "doi" => "10.1016/j.ajhg.2011.10.005"
                      "Revista" => array:6 [
                        "tituloSerie" => "Am J Hum Genet"
                        "fecha" => "2011"
                        "volumen" => "89"
                        "paginaInicial" => "656"
                        "paginaFinal" => "667"
                        "link" => array:1 [
                          0 => array:2 [
                            "url" => "https://www.ncbi.nlm.nih.gov/pubmed/22077971"
                            "web" => "Medline"
                          ]
                        ]
                      ]
                    ]
                  ]
                ]
              ]
            ]
            2 => array:3 [
              "identificador" => "bib0015"
              "etiqueta" => "3"
              "referencia" => array:1 [
                0 => array:2 [
                  "contribucion" => array:1 [
                    0 => array:2 [
                      "titulo" => "Nonketotic hyperglycinemia presenting as pulmonary hypertensive vascular disease and fatal pulmonary edema in response to pulmonary vasodilator therapy"
                      "autores" => array:1 [
                        0 => array:2 [
                          "etal" => false
                          "autores" => array:6 [
                            0 => "J&#46;J&#46; Men&#233;ndez Suso"
                            1 => "M&#46;J&#46; del Cerro Mar&#237;n"
                            2 => "P&#46; Dorao Mart&#237;nez-Romillo"
                            3 => "C&#46; Labrandero de Lera"
                            4 => "L&#46; Fern&#225;ndez Garc&#237;a-Moya"
                            5 => "J&#46;I&#46; Rodr&#237;guez Gonz&#225;lez"
                          ]
                        ]
                      ]
                    ]
                  ]
                  "host" => array:1 [
                    0 => array:2 [
                      "doi" => "10.1016/j.jpeds.2012.04.044"
                      "Revista" => array:6 [
                        "tituloSerie" => "J Pediatr"
                        "fecha" => "2012"
                        "volumen" => "161"
                        "paginaInicial" => "557"
                        "paginaFinal" => "559"
                        "link" => array:1 [
                          0 => array:2 [
                            "url" => "https://www.ncbi.nlm.nih.gov/pubmed/22658788"
                            "web" => "Medline"
                          ]
                        ]
                      ]
                    ]
                  ]
                ]
              ]
            ]
            3 => array:3 [
              "identificador" => "bib0020"
              "etiqueta" => "4"
              "referencia" => array:1 [
                0 => array:2 [
                  "contribucion" => array:1 [
                    0 => array:2 [
                      "titulo" => "Clinical&#44; biochemical&#44; and genetic spectrum of seven patients with NFU1 deficiency"
                      "autores" => array:1 [
                        0 => array:2 [
                          "etal" => true
                          "autores" => array:6 [
                            0 => "U&#46; Ahting"
                            1 => "J&#46;A&#46; Mayr"
                            2 => "A&#46;V&#46; Vanlander"
                            3 => "S&#46;A&#46; Hardy"
                            4 => "S&#46; Santra"
                            5 => "C&#46; Makowski"
                          ]
                        ]
                      ]
                    ]
                  ]
                  "host" => array:1 [
                    0 => array:2 [
                      "doi" => "10.3389/fgene.2015.00123"
                      "Revista" => array:5 [
                        "tituloSerie" => "Front Genet"
                        "fecha" => "2015"
                        "volumen" => "6"
                        "paginaInicial" => "123"
                        "link" => array:1 [
                          0 => array:2 [
                            "url" => "https://www.ncbi.nlm.nih.gov/pubmed/25918518"
                            "web" => "Medline"
                          ]
                        ]
                      ]
                    ]
                  ]
                ]
              ]
            ]
            4 => array:3 [
              "identificador" => "bib0025"
              "etiqueta" => "5"
              "referencia" => array:1 [
                0 => array:2 [
                  "contribucion" => array:1 [
                    0 => array:2 [
                      "titulo" => "Cavitating leukoencephalopathy with multiple mitocondrial dysfunction s&#237;ndrome and NFU1mutations"
                      "autores" => array:1 [
                        0 => array:2 [
                          "etal" => true
                          "autores" => array:6 [
                            0 => "F&#46; Invernizzi"
                            1 => "A&#46; Ardissone"
                            2 => "E&#46; Lamantea"
                            3 => "B&#46; Garavaglia"
                            4 => "M&#46; Zeviani"
                            5 => "L&#46; Farina"
                          ]
                        ]
                      ]
                    ]
                  ]
                  "host" => array:1 [
                    0 => array:2 [
                      "doi" => "10.3389/fgene.2014.00412"
                      "Revista" => array:5 [
                        "tituloSerie" => "Front&#46; Genet"
                        "fecha" => "2014"
                        "volumen" => "5"
                        "paginaInicial" => "412"
                        "link" => array:1 [
                          0 => array:2 [
                            "url" => "https://www.ncbi.nlm.nih.gov/pubmed/25477904"
                            "web" => "Medline"
                          ]
                        ]
                      ]
                    ]
                  ]
                ]
              ]
            ]
            5 => array:3 [
              "identificador" => "bib0030"
              "etiqueta" => "6"
              "referencia" => array:1 [
                0 => array:2 [
                  "contribucion" => array:1 [
                    0 => array:2 [
                      "titulo" => "Leukoencephalopathy with cysts and hyperglycinemia may result from NFU1deficiency"
                      "autores" => array:1 [
                        0 => array:2 [
                          "etal" => true
                          "autores" => array:6 [
                            0 => "M&#46; Nizon"
                            1 => "A&#46; Boutron"
                            2 => "N&#46; Boddaert"
                            3 => "A&#46; Slama"
                            4 => "H&#46; Delpech"
                            5 => "C&#46; Sardet"
                          ]
                        ]
                      ]
                    ]
                  ]
                  "host" => array:1 [
                    0 => array:2 [
                      "doi" => "10.1016/j.mito.2014.01.003"
                      "Revista" => array:6 [
                        "tituloSerie" => "Mitochondrion"
                        "fecha" => "2014"
                        "volumen" => "15"
                        "paginaInicial" => "59"
                        "paginaFinal" => "64"
                        "link" => array:1 [
                          0 => array:2 [
                            "url" => "https://www.ncbi.nlm.nih.gov/pubmed/24462778"
                            "web" => "Medline"
                          ]
                        ]
                      ]
                    ]
                  ]
                ]
              ]
            ]
            6 => array:3 [
              "identificador" => "bib0035"
              "etiqueta" => "7"
              "referencia" => array:1 [
                0 => array:2 [
                  "contribucion" => array:1 [
                    0 => array:2 [
                      "titulo" => "Guidelines on the diagnosis and treatment of pulmonary hypertension&#58; summary of recommendations"
                      "autores" => array:1 [
                        0 => array:2 [
                          "etal" => true
                          "autores" => array:6 [
                            0 => "J&#46;A&#46; Barber&#224;"
                            1 => "A&#46; Rom&#225;n"
                            2 => "M&#46;A&#46; G&#243;mez-S&#225;nchez"
                            3 => "I&#46; Blanco"
                            4 => "R&#46; Otero"
                            5 => "R&#46; L&#243;pez-Reyes"
                          ]
                        ]
                      ]
                    ]
                  ]
                  "host" => array:1 [
                    0 => array:2 [
                      "doi" => "10.1016/j.arbres.2017.11.014"
                      "Revista" => array:6 [
                        "tituloSerie" => "Arch Bronconeumol"
                        "fecha" => "2018"
                        "volumen" => "54"
                        "paginaInicial" => "205"
                        "paginaFinal" => "215"
                        "link" => array:1 [
                          0 => array:2 [
                            "url" => "https://www.ncbi.nlm.nih.gov/pubmed/29472044"
                            "web" => "Medline"
                          ]
                        ]
                      ]
                    ]
                  ]
                ]
              ]
            ]
            7 => array:3 [
              "identificador" => "bib0040"
              "etiqueta" => "8"
              "referencia" => array:1 [
                0 => array:2 [
                  "contribucion" => array:1 [
                    0 => array:2 [
                      "titulo" => "Protein expression profiles in patients carrying NFU1 mutations&#46; Contribution to the pathophysiology of the disease"
                      "autores" => array:1 [
                        0 => array:2 [
                          "etal" => false
                          "autores" => array:6 [
                            0 => "X&#46; Ferrer-Cort&#233;s"
                            1 => "A&#46; Font"
                            2 => "N&#46; Bujan"
                            3 => "A&#46; Navarro-Sastre"
                            4 => "L&#46; Matalonga"
                            5 => "J&#46;A&#46; Arranz"
                          ]
                        ]
                      ]
                    ]
                  ]
                  "host" => array:1 [
                    0 => array:2 [
                      "doi" => "10.1007/s10545-012-9565-z"
                      "Revista" => array:6 [
                        "tituloSerie" => "J Inherit Metab Dis"
                        "fecha" => "2013"
                        "volumen" => "36"
                        "paginaInicial" => "841"
                        "paginaFinal" => "847"
                        "link" => array:1 [
                          0 => array:2 [
                            "url" => "https://www.ncbi.nlm.nih.gov/pubmed/23179554"
                            "web" => "Medline"
                          ]
                        ]
                      ]
                    ]
                  ]
                ]
              ]
            ]
            8 => array:3 [
              "identificador" => "bib0045"
              "etiqueta" => "9"
              "referencia" => array:1 [
                0 => array:2 [
                  "contribucion" => array:1 [
                    0 => array:2 [
                      "titulo" => "Impact of mutations within the &#91;Fe-S&#93; cluster or the lipoic acid biosynthesis pathways on mitochondrial protein expression profiles in fibroblasts from patients"
                      "autores" => array:1 [
                        0 => array:2 [
                          "etal" => false
                          "autores" => array:6 [
                            0 => "E&#46; Lebigot"
                            1 => "P&#46; Gaignard"
                            2 => "I&#46; Dorboz"
                            3 => "A&#46; Slama"
                            4 => "M&#46; Rio"
                            5 => "P&#46; de Lonlay"
                          ]
                        ]
                      ]
                    ]
                  ]
                  "host" => array:1 [
                    0 => array:2 [
                      "doi" => "10.1016/j.ymgme.2017.08.001"
                      "Revista" => array:6 [
                        "tituloSerie" => "Mol Genet Metab"
                        "fecha" => "2017"
                        "volumen" => "122"
                        "paginaInicial" => "85"
                        "paginaFinal" => "94"
                        "link" => array:1 [
                          0 => array:2 [
                            "url" => "https://www.ncbi.nlm.nih.gov/pubmed/28803783"
                            "web" => "Medline"
                          ]
                        ]
                      ]
                    ]
                  ]
                ]
              ]
            ]
            9 => array:3 [
              "identificador" => "bib0050"
              "etiqueta" => "10"
              "referencia" => array:1 [
                0 => array:2 [
                  "contribucion" => array:1 [
                    0 => array:2 [
                      "titulo" => "Understanding the molecular basis of multiple mitochondrial dysfunctions syndrome 1 &#40;MMDS1&#41;&#8212;impact of a disease-causing Gly208Cys substitution on structure and activity of NFU1 in the Fe&#47;S cluster biosynthetic pathway"
                      "autores" => array:1 [
                        0 => array:2 [
                          "etal" => false
                          "autores" => array:4 [
                            0 => "C&#46; Wachnowsky"
                            1 => "N&#46;A&#46; Wesley"
                            2 => "I&#46; Fidai"
                            3 => "J&#46;A&#46; Cowan"
                          ]
                        ]
                      ]
                    ]
                  ]
                  "host" => array:1 [
                    0 => array:2 [
                      "doi" => "10.1016/j.jmb.2017.01.021"
                      "Revista" => array:6 [
                        "tituloSerie" => "J Mol Biol"
                        "fecha" => "2017"
                        "volumen" => "429"
                        "paginaInicial" => "790"
                        "paginaFinal" => "807"
                        "link" => array:1 [
                          0 => array:2 [
                            "url" => "https://www.ncbi.nlm.nih.gov/pubmed/28161430"
                            "web" => "Medline"
                          ]
                        ]
                      ]
                    ]
                  ]
                ]
              ]
            ]
            10 => array:3 [
              "identificador" => "bib0055"
              "etiqueta" => "11"
              "referencia" => array:1 [
                0 => array:2 [
                  "contribucion" => array:1 [
                    0 => array:2 [
                      "titulo" => "NFU1-related disorders as key differential diagnosis of cavitating leukoencephalopathy"
                      "autores" => array:1 [
                        0 => array:2 [
                          "etal" => false
                          "autores" => array:6 [
                            0 => "P&#46;V&#46;S&#46; De Souza"
                            1 => "T&#46; Bortholin"
                            2 => "S&#46; Burlin"
                            3 => "F&#46;G&#46;M&#46; Naylor"
                            4 => "W&#46;B&#46;V&#46;R&#46; Pinto"
                            5 => "A&#46;S&#46;B&#46; Oliveira"
                          ]
                        ]
                      ]
                    ]
                  ]
                  "host" => array:1 [
                    0 => array:2 [
                      "doi" => "10.1055/s-0037-1606295"
                      "Revista" => array:6 [
                        "tituloSerie" => "J Pediatr Genet"
                        "fecha" => "2018"
                        "volumen" => "7"
                        "paginaInicial" => "40"
                        "paginaFinal" => "42"
                        "link" => array:1 [
                          0 => array:2 [
                            "url" => "https://www.ncbi.nlm.nih.gov/pubmed/29441221"
                            "web" => "Medline"
                          ]
                        ]
                      ]
                    ]
                  ]
                ]
              ]
            ]
          ]
        ]
      ]
    ]
  ]
  "idiomaDefecto" => "en"
  "url" => "/15792129/0000005600000012/v1_202012151701/S1579212920302834/v1_202012151701/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/15792129/0000005600000012/v1_202012151701/S1579212920302834/v1_202012151701/en/main.pdf?idApp=UINPBA00003Z&text.app=https://archbronconeumol.org/"
  "EPUB" => "https://multimedia.elsevier.es/PublicationsMultimediaV1/item/epub/S1579212920302834?idApp=UINPBA00003Z"
]
Article information
ISSN: 15792129
Original language: English
The statistics are updated each day
Year/Month Html Pdf Total
2024 November 7 8 15
2024 October 43 21 64
2024 September 63 21 84
2024 August 78 38 116
2024 July 44 20 64
2024 June 58 41 99
2024 May 86 37 123
2024 April 33 30 63
2024 March 36 20 56
2024 February 22 22 44
2023 March 10 4 14
2023 February 48 25 73
2023 January 33 30 63
2022 December 62 32 94
2022 November 57 30 87
2022 October 52 33 85
2022 September 53 27 80
2022 August 33 44 77
2022 July 43 53 96
2022 June 48 42 90
2022 May 41 27 68
2022 April 45 42 87
2022 March 58 38 96
2022 February 23 24 47
2021 March 2 2 4
2020 December 1 0 1
Show all

Follow this link to access the full text of the article

Archivos de Bronconeumología

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