array:23 [
  "pii" => "S0300289615326156"
  "issn" => "03002896"
  "doi" => "10.1016/S0300-2896(15)32615-6"
  "estado" => "S300"
  "fechaPublicacion" => "1978-07-01"
  "aid" => "72684"
  "copyright" => "Sociedad Española de Neumología y Cirugía Torácica"
  "copyrightAnyo" => "1978"
  "documento" => "article"
  "crossmark" => 0
  "subdocumento" => "fla"
  "cita" => "Arch Bronconeumol. 1978;14:128-31"
  "abierto" => array:3 [
    "ES" => true
    "ES2" => true
    "LATM" => true
  ]
  "gratuito" => true
  "lecturas" => array:2 [
    "total" => 1558
    "formatos" => array:3 [
      "EPUB" => 60
      "HTML" => 893
      "PDF" => 605
    ]
  ]
  "itemSiguiente" => array:18 [
    "pii" => "S0300289615326168"
    "issn" => "03002896"
    "doi" => "10.1016/S0300-2896(15)32616-8"
    "estado" => "S300"
    "fechaPublicacion" => "1978-07-01"
    "aid" => "72685"
    "copyright" => "Sociedad Española de Neumología y Cirugía Torácica"
    "documento" => "article"
    "crossmark" => 0
    "subdocumento" => "fla"
    "cita" => "Arch Bronconeumol. 1978;14:132-4"
    "abierto" => array:3 [
      "ES" => true
      "ES2" => true
      "LATM" => true
    ]
    "gratuito" => true
    "lecturas" => array:2 [
      "total" => 1170
      "formatos" => array:3 [
        "EPUB" => 63
        "HTML" => 633
        "PDF" => 474
      ]
    ]
    "es" => array:10 [
      "idiomaDefecto" => true
      "titulo" => "Quiste broncogenico y agenesia del pericardio"
      "tienePdf" => "es"
      "tieneTextoCompleto" => 0
      "tieneResumen" => array:2 [
        0 => "es"
        1 => "en"
      ]
      "paginas" => array:1 [
        0 => array:2 [
          "paginaInicial" => "132"
          "paginaFinal" => "134"
        ]
      ]
      "titulosAlternativos" => array:1 [
        "en" => array:1 [
          "titulo" => "Bronchogenic cyst and agenesia of the pericardium"
        ]
      ]
      "contieneResumen" => array:2 [
        "es" => true
        "en" => true
      ]
      "contienePdf" => array:1 [
        "es" => true
      ]
      "autores" => array:1 [
        0 => array:2 [
          "autoresLista" => "A. Esteban Hernández, E. Ortiz Villajos, J. Relanzón López"
          "autores" => array:3 [
            0 => array:2 [
              "nombre" => "A."
              "apellidos" => "Esteban Hernández"
            ]
            1 => array:2 [
              "nombre" => "E."
              "apellidos" => "Ortiz Villajos"
            ]
            2 => array:2 [
              "nombre" => "J."
              "apellidos" => "Relanzón López"
            ]
          ]
        ]
      ]
    ]
    "idiomaDefecto" => "es"
    "EPUB" => "https://multimedia.elsevier.es/PublicationsMultimediaV1/item/epub/S0300289615326168?idApp=UINPBA00003Z"
    "url" => "/03002896/0000001400000003/v1_201509151322/S0300289615326168/v1_201509151322/es/main.assets"
  ]
  "itemAnterior" => array:18 [
    "pii" => "S0300289615326144"
    "issn" => "03002896"
    "doi" => "10.1016/S0300-2896(15)32614-4"
    "estado" => "S300"
    "fechaPublicacion" => "1978-07-01"
    "aid" => "72683"
    "copyright" => "Sociedad Española de Neumología y Cirugía Torácica"
    "documento" => "article"
    "crossmark" => 0
    "subdocumento" => "fla"
    "cita" => "Arch Bronconeumol. 1978;14:125-7"
    "abierto" => array:3 [
      "ES" => true
      "ES2" => true
      "LATM" => true
    ]
    "gratuito" => true
    "lecturas" => array:2 [
      "total" => 1388
      "formatos" => array:3 [
        "EPUB" => 50
        "HTML" => 838
        "PDF" => 500
      ]
    ]
    "es" => array:10 [
      "idiomaDefecto" => true
      "titulo" => "Edema pulmonar unilateral"
      "tienePdf" => "es"
      "tieneTextoCompleto" => 0
      "tieneResumen" => array:2 [
        0 => "es"
        1 => "en"
      ]
      "paginas" => array:1 [
        0 => array:2 [
          "paginaInicial" => "125"
          "paginaFinal" => "127"
        ]
      ]
      "titulosAlternativos" => array:1 [
        "en" => array:1 [
          "titulo" => "Unilateral pulmonary edema"
        ]
      ]
      "contieneResumen" => array:2 [
        "es" => true
        "en" => true
      ]
      "contienePdf" => array:1 [
        "es" => true
      ]
      "autores" => array:1 [
        0 => array:2 [
          "autoresLista" => "F. Bertomeu, A. Grau, A. Anguiz, J. Luna, V. Montagut, J.M. Pepio, D. Bofill, B. Cabrer"
          "autores" => array:8 [
            0 => array:2 [
              "nombre" => "F."
              "apellidos" => "Bertomeu"
            ]
            1 => array:2 [
              "nombre" => "A."
              "apellidos" => "Grau"
            ]
            2 => array:2 [
              "nombre" => "A."
              "apellidos" => "Anguiz"
            ]
            3 => array:2 [
              "nombre" => "J."
              "apellidos" => "Luna"
            ]
            4 => array:2 [
              "nombre" => "V."
              "apellidos" => "Montagut"
            ]
            5 => array:2 [
              "nombre" => "J.M."
              "apellidos" => "Pepio"
            ]
            6 => array:2 [
              "nombre" => "D."
              "apellidos" => "Bofill"
            ]
            7 => array:2 [
              "nombre" => "B."
              "apellidos" => "Cabrer"
            ]
          ]
        ]
      ]
    ]
    "idiomaDefecto" => "es"
    "EPUB" => "https://multimedia.elsevier.es/PublicationsMultimediaV1/item/epub/S0300289615326144?idApp=UINPBA00003Z"
    "url" => "/03002896/0000001400000003/v1_201509151322/S0300289615326144/v1_201509151322/es/main.assets"
  ]
  "es" => array:12 [
    "idiomaDefecto" => true
    "titulo" => "Hipertension arterial pulmonar por sindrome crest"
    "tieneTextoCompleto" => 0
    "paginas" => array:1 [
      0 => array:2 [
        "paginaInicial" => "128"
        "paginaFinal" => "131"
      ]
    ]
    "autores" => array:1 [
      0 => array:3 [
        "autoresLista" => "J. Menéndez del Campo, J.L. Carretero Sastre, A. Ribas Barceló, J.A. Mosquera Pestaña"
        "autores" => array:4 [
          0 => array:3 [
            "nombre" => "J."
            "apellidos" => "Menéndez del Campo"
            "referencia" => array:1 [
              0 => array:2 [
                "etiqueta" => "<span class="elsevierStyleSup">&#42;</span>"
                "identificador" => "aff0005"
              ]
            ]
          ]
          1 => array:3 [
            "nombre" => "J&#46;L&#46;"
            "apellidos" => "Carretero Sastre"
            "referencia" => array:1 [
              0 => array:2 [
                "etiqueta" => "<span class="elsevierStyleSup">&#42;&#42;</span>"
                "identificador" => "aff0010"
              ]
            ]
          ]
          2 => array:3 [
            "nombre" => "A&#46;"
            "apellidos" => "Ribas Barcel&#243;"
            "referencia" => array:1 [
              0 => array:2 [
                "etiqueta" => "<span class="elsevierStyleSup">&#42;&#42;&#42;</span>"
                "identificador" => "aff0015"
              ]
            ]
          ]
          3 => array:3 [
            "nombre" => "J&#46;A&#46;"
            "apellidos" => "Mosquera Pesta&#241;a"
            "referencia" => array:1 [
              0 => array:2 [
                "etiqueta" => "<span class="elsevierStyleSup">&#42;&#42;&#42;&#42;</span>"
                "identificador" => "aff0020"
              ]
            ]
          ]
        ]
        "afiliaciones" => array:4 [
          0 => array:3 [
            "entidad" => "M&#233;dico Adjunto al Servicio de Neumolog&#237;a&#46; &#40;I&#46;N&#46;S&#46;&#41;&#46; Instituto Nacional de Silicosis&#46; Hospital General de Asturias&#46; Oviedo"
            "etiqueta" => "&#42;"
            "identificador" => "aff0005"
          ]
          1 => array:3 [
            "entidad" => "Jefe Cl&#237;nico Servido de Neumolog&#237;a &#40;I&#46;N&#46;S&#46;&#41;&#46; Instituto Nacional de Silicosis&#46; Hospital General de Asturias&#46; Oviedo"
            "etiqueta" => "&#42;&#42;"
            "identificador" => "aff0010"
          ]
          2 => array:3 [
            "entidad" => "Jet&#233; del Servicio de Anatom&#237;a Patoi&#243;g&#233;ca &#40;H&#46;G&#46;A&#46;&#41; Instituto Nacional de Silicosis&#46; Hospital General de Asturias&#46; Oviedo"
            "etiqueta" => "&#42;&#42;&#42;"
            "identificador" => "aff0015"
          ]
          3 => array:3 [
            "entidad" => "Jefe del Servicio de Neumolog&#237;a &#40;I&#46;N&#46;S&#46;&#41;&#46; Instituto Nacional de Silicosis&#46; Hospital General de Asturias&#46; Oviedo"
            "etiqueta" => "&#42;&#42;&#42;&#42;"
            "identificador" => "aff0020"
          ]
        ]
      ]
    ]
    "titulosAlternativos" => array:1 [
      "en" => array:1 [
        "titulo" => "Pulmonary arterial hypertension by crest&#39;s syndrome"
      ]
    ]
    "pdfFichero" => "main.pdf"
    "tienePdf" => true
    "fechaRecibido" => "1978-01-04"
    "tieneResumen" => true
    "resumen" => array:2 [
      "es" => array:2 [
        "titulo" => "Resumen"
        "resumen" => "<span id="abst0005" class="elsevierStyleSection elsevierViewall"><p id="spar0005" class="elsevierStyleSimplePara elsevierViewall">Se presenta 1 paciente de 52 a&#241;os con disnea progresiva de 4 a&#241;os deevoluci&#243;n&#44; cl&#237;nica recidivante de fallo cardiaco derecho&#44; telangiectasias&#44; esclerodactilica y Raynaud bilateral&#46;</p><p id="spar0010" class="elsevierStyleSimplePara elsevierViewall">Sus vol&#250;menes pulmonares&#44; resis tencias al flujo&#44; compliance st&#225;tica y DLCO eran normales&#46;</p><p id="spar0015" class="elsevierStyleSimplePara elsevierViewall">Electrocardiograma y Vectocardiograma mostraba hipertrofia de ventr&#237;culo derecho&#46; El cateterismo derecho e izquierdo mostr&#243; hipertensi&#243;n pulmonar severa con presi&#243;n en cu&#241;a normal y sin patolog&#237;a del coraz&#243;n izquierdo&#46; La angiograf&#237;a pulmonar descart&#243; tromboembolismo de grandes troncos arteriales&#46;</p><p id="spar0020" class="elsevierStyleSimplePara elsevierViewall">La biopsia pulmonar abierta mostr&#243; moderada fibrosis intesticial y&#44; sobre todo&#44; acentuadas lesiones en la &#237;ntima de las arterias de mediano y peque&#241;o calibre&#46;</p><p id="spar0025" class="elsevierStyleSimplePara elsevierViewall">El diagn&#243;stico etiopatog&#233;nico de la hipertensi&#243;n pulmonar es dif&#237;cil y exige medidas diagn&#243;sticas agresivas para separar las distintas entidades que lo producen y especialmente tromboembolismo pulmonar de peque&#241;os vasos&#46;</p><p id="spar0030" class="elsevierStyleSimplePara elsevierViewall">Calcinosis&#44; Raynaud&#44; esclerodactilia&#44; afectaci&#243;n de es&#243;fago y telangiectasias &#40;s&#237;ndrome de CREST o CRST&#41;&#44; son formas menores de esclerosis sist&#233;ntica y se han considerado de pronostico benigno&#46;</p><p id="spar0035" class="elsevierStyleSimplePara elsevierViewall">Este paciente&#44; junto a otros 13 descritos en la literatura son portadores de una hipertensi&#243;n pulmonar por lesi&#243;n vascular&#44; poniendo en tela de juicio la benignidad del proceso&#46;</p></span>"
      ]
      "en" => array:2 [
        "titulo" => "Summary"
        "resumen" => "<span id="abst0010" class="elsevierStyleSection elsevierViewall"><p id="spar0040" class="elsevierStyleSimplePara elsevierViewall">The authors present the case of a 52-year-old patient with progressive dyspnea with a 4 year evolution&#44; dinical relapse of right cardiac failure&#44; telangiectasia&#44; sclerodactylia and bilateral Raynaud&#46;</p><p id="spar0045" class="elsevierStyleSimplePara elsevierViewall">His pulmonary volumes&#44; resistance to flow&#44; static compliance and DLCO were normal&#46;</p><p id="spar0050" class="elsevierStyleSimplePara elsevierViewall">The electrocardiogram and vectora rdiogram showed hypertrophy of the right ventride&#46; Right and left catheterism showed severe pulmonary hypertension with pressure in normal wedge and without pathology of the left heart&#46; Pulmonary angiography discarted thrombo-embolism of large arterial trunks&#46;</p><p id="spar0055" class="elsevierStyleSimplePara elsevierViewall">Open pulmonary biopsy showed moderated interstitial fibrosis and&#44; above all&#44; acentuated lesions in the intima of the arteries of medium and small caliber&#46;</p></span>"
      ]
    ]
    "bibliografia" => array:2 [
      "titulo" => "Bibliografia"
      "seccion" => array:1 [
        0 => array:2 [
          "identificador" => "bibs0005"
          "bibliografiaReferencia" => array:20 [
            0 => array:3 [
              "identificador" => "bib0005"
              "etiqueta" => "1&#46;"
              "referencia" => array:1 [
                0 => array:2 [
                  "contribucion" => array:1 [
                    0 => array:1 [
                      "titulo" => "Editorial Pulmonary veno-occlusive disease"
                    ]
                  ]
                  "host" => array:1 [
                    0 => array:1 [
                      "Revista" => array:5 [
                        "tituloSerie" => "Brit&#46; Med&#46; J&#46;"
                        "fecha" => "1972"
                        "volumen" => "3"
                        "paginaInicial" => "369"
                        "link" => array:1 [
                          0 => array:2 [
                            "url" => "https://www.ncbi.nlm.nih.gov/pubmed/1156769"
                            "web" => "Medline"
                          ]
                        ]
                      ]
                    ]
                  ]
                ]
              ]
            ]
            1 => array:3 [
              "identificador" => "bib0010"
              "etiqueta" => "2&#46;"
              "referencia" => array:1 [
                0 => array:2 [
                  "contribucion" => array:1 [
                    0 => array:2 [
                      "titulo" => "Pulmonary granulomas in a patient with pulmonary veno-occlusive disease"
                      "autores" => array:1 [
                        0 => array:2 [
                          "etal" => false
                          "autores" => array:3 [
                            0 => "E&#46;N&#46; Schachter"
                            1 => "J&#46;W&#46; Smith"
                            2 => "G&#46;S&#46; Cohen"
                          ]
                        ]
                      ]
                    ]
                  ]
                  "host" => array:1 [
                    0 => array:1 [
                      "Revista" => array:5 [
                        "tituloSerie" => "Chest"
                        "fecha" => "1975"
                        "volumen" => "67"
                        "paginaInicial" => "487"
                        "link" => array:1 [
                          0 => array:2 [
                            "url" => "https://www.ncbi.nlm.nih.gov/pubmed/1122783"
                            "web" => "Medline"
                          ]
                        ]
                      ]
                    ]
                  ]
                ]
              ]
            ]
            2 => array:3 [
              "identificador" => "bib0015"
              "etiqueta" => "3&#46;"
              "referencia" => array:1 [
                0 => array:2 [
                  "contribucion" => array:1 [
                    0 => array:2 [
                      "titulo" => "A case of pulmonary veno-occlusive disease responding to treatnrent with azathioprime"
                      "autores" => array:1 [
                        0 => array:2 [
                          "etal" => false
                          "autores" => array:4 [
                            0 => "J&#46;E&#46; Sanderson"
                            1 => "S&#46;G&#46; Spiro"
                            2 => "A&#46;T&#46; Hendry"
                            3 => "M&#46; Turner-Warwich"
                          ]
                        ]
                      ]
                    ]
                  ]
                  "host" => array:1 [
                    0 => array:1 [
                      "Revista" => array:5 [
                        "tituloSerie" => "Thorax"
                        "fecha" => "1977"
                        "volumen" => "32"
                        "paginaInicial" => "140"
                        "link" => array:1 [
                          0 => array:2 [
                            "url" => "https://www.ncbi.nlm.nih.gov/pubmed/867325"
                            "web" => "Medline"
                          ]
                        ]
                      ]
                    ]
                  ]
                ]
              ]
            ]
            3 => array:3 [
              "identificador" => "bib0020"
              "etiqueta" => "4&#46;"
              "referencia" => array:1 [
                0 => array:2 [
                  "contribucion" => array:1 [
                    0 => array:2 [
                      "titulo" => "A pulmonary hypertension producing plant from tanzania"
                      "autores" => array:1 [
                        0 => array:2 [
                          "etal" => false
                          "autores" => array:3 [
                            0 => "D&#46; Heath"
                            1 => "J&#46; Shaba"
                            2 => "A&#46; Williams"
                          ]
                        ]
                      ]
                    ]
                  ]
                  "host" => array:1 [
                    0 => array:1 [
                      "Revista" => array:5 [
                        "tituloSerie" => "Thorax&#46;"
                        "fecha" => "1975"
                        "volumen" => "30"
                        "paginaInicial" => "399"
                        "link" => array:1 [
                          0 => array:2 [
                            "url" => "https://www.ncbi.nlm.nih.gov/pubmed/126502"
                            "web" => "Medline"
                          ]
                        ]
                      ]
                    ]
                  ]
                ]
              ]
            ]
            4 => array:3 [
              "identificador" => "bib0025"
              "etiqueta" => "5&#46;"
              "referencia" => array:1 [
                0 => array:2 [
                  "contribucion" => array:1 [
                    0 => array:2 [
                      "titulo" => "Pulmonary hypertension"
                      "autores" => array:1 [
                        0 => array:2 [
                          "etal" => false
                          "autores" => array:2 [
                            0 => "H&#46; Herzog"
                            1 => "J&#46; Widimsky"
                          ]
                        ]
                      ]
                    ]
                  ]
                  "host" => array:1 [
                    0 => array:1 [
                      "Libro" => array:4 [
                        "fecha" => "1975"
                        "paginaInicial" => "Pag55"
                        "editorial" => "S&#46; Karger"
                        "editorialLocalizacion" => "Basilea"
                      ]
                    ]
                  ]
                ]
              ]
            ]
            5 => array:3 [
              "identificador" => "bib0030"
              "etiqueta" => "6&#46;"
              "referencia" => array:1 [
                0 => array:2 [
                  "contribucion" => array:1 [
                    0 => array:2 [
                      "titulo" => "The pulmonary hypoxic response&#58; State of the field"
                      "autores" => array:1 [
                        0 => array:2 [
                          "etal" => false
                          "autores" => array:1 [
                            0 => "D&#46;F&#46; Bohr"
                          ]
                        ]
                      ]
                    ]
                  ]
                  "host" => array:1 [
                    0 => array:1 [
                      "Revista" => array:5 [
                        "tituloSerie" => "Chest"
                        "fecha" => "1977"
                        "volumen" => "71"
                        "paginaInicial" => "2"
                        "link" => array:1 [
                          0 => array:2 [
                            "url" => "https://www.ncbi.nlm.nih.gov/pubmed/830494"
                            "web" => "Medline"
                          ]
                        ]
                      ]
                    ]
                  ]
                ]
              ]
            ]
            6 => array:3 [
              "identificador" => "bib0035"
              "etiqueta" => "7&#46;"
              "referencia" => array:1 [
                0 => array:2 [
                  "contribucion" => array:1 [
                    0 => array:2 [
                      "titulo" => "Cor pulmonale &#40;Pulmonary heart disease&#41; present-day status"
                      "autores" => array:1 [
                        0 => array:2 [
                          "etal" => false
                          "autores" => array:1 [
                            0 => "M&#46; Irene Ferrer"
                          ]
                        ]
                      ]
                    ]
                  ]
                  "host" => array:1 [
                    0 => array:1 [
                      "Revista" => array:4 [
                        "tituloSerie" => "Amer&#46; Heart&#46; Jour&#46;"
                        "fecha" => "1975"
                        "volumen" => "89"
                        "paginaInicial" => "657"
                      ]
                    ]
                  ]
                ]
              ]
            ]
            7 => array:3 [
              "identificador" => "bib0040"
              "etiqueta" => "8&#46;"
              "referencia" => array:1 [
                0 => array:2 [
                  "contribucion" => array:1 [
                    0 => array:1 [
                      "autores" => array:1 [
                        0 => array:2 [
                          "etal" => false
                          "autores" => array:3 [
                            0 => "G&#46;V&#46; Sharma"
                            1 => "A&#46;A&#46; Sasahara"
                            2 => "K&#46;M&#46; Mcintyre"
                          ]
                        ]
                      ]
                    ]
                  ]
                  "host" => array:1 [
                    0 => array:1 [
                      "Revista" => array:2 [
                        "tituloSerie" => "Pulmonary embolism&#58; the great imitator <span class="elsevierStyleItalic">D&#46;M</span>"
                        "fecha" => "1976"
                      ]
                    ]
                  ]
                ]
              ]
            ]
            8 => array:3 [
              "identificador" => "bib0045"
              "etiqueta" => "9&#46;"
              "referencia" => array:1 [
                0 => array:2 [
                  "contribucion" => array:1 [
                    0 => array:2 [
                      "titulo" => "Pulmonary embolism"
                      "autores" => array:1 [
                        0 => array:2 [
                          "etal" => false
                          "autores" => array:1 [
                            0 => "K&#46;M&#46; Moser"
                          ]
                        ]
                      ]
                    ]
                  ]
                  "host" => array:1 [
                    0 => array:2 [
                      "doi" => "10.1164/arrd.1977.115.5.829"
                      "Revista" => array:5 [
                        "tituloSerie" => "Am&#46; Rev&#46; Resp&#46; Dis&#46;"
                        "fecha" => "1977"
                        "volumen" => "115"
                        "paginaInicial" => "829"
                        "link" => array:1 [
                          0 => array:2 [
                            "url" => "https://www.ncbi.nlm.nih.gov/pubmed/855959"
                            "web" => "Medline"
                          ]
                        ]
                      ]
                    ]
                  ]
                ]
              ]
            ]
            9 => array:3 [
              "identificador" => "bib0050"
              "etiqueta" => "10&#46;"
              "referencia" => array:1 [
                0 => array:2 [
                  "contribucion" => array:1 [
                    0 => array:2 [
                      "titulo" => "Vasculitis syndromes&#58; Clinical and experimental models"
                      "autores" => array:1 [
                        0 => array:2 [
                          "etal" => false
                          "autores" => array:2 [
                            0 => "C&#46;L&#46; Christian"
                            1 => "J&#46;S&#46; Sergent"
                          ]
                        ]
                      ]
                    ]
                  ]
                  "host" => array:1 [
                    0 => array:1 [
                      "Revista" => array:4 [
                        "tituloSerie" => "Am&#46; Heart&#46; Jour&#46;"
                        "fecha" => "1975"
                        "volumen" => "89"
                        "paginaInicial" => "657"
                      ]
                    ]
                  ]
                ]
              ]
            ]
            10 => array:3 [
              "identificador" => "bib0055"
              "etiqueta" => "11&#46;"
              "referencia" => array:1 [
                0 => array:2 [
                  "contribucion" => array:1 [
                    0 => array:2 [
                      "titulo" => "Unexplained pulmonary hypertension with pulmonary arteritis in rheumatoid disease"
                      "autores" => array:1 [
                        0 => array:2 [
                          "etal" => false
                          "autores" => array:2 [
                            0 => "J&#46;M&#46; Kay"
                            1 => "S&#46; Banik"
                          ]
                        ]
                      ]
                    ]
                  ]
                  "host" => array:1 [
                    0 => array:1 [
                      "Revista" => array:5 [
                        "tituloSerie" => "Brit&#46; J&#46; Dis&#46; Chest&#46;"
                        "fecha" => "1977"
                        "volumen" => "71"
                        "paginaInicial" => "53"
                        "link" => array:1 [
                          0 => array:2 [
                            "url" => "https://www.ncbi.nlm.nih.gov/pubmed/831768"
                            "web" => "Medline"
                          ]
                        ]
                      ]
                    ]
                  ]
                ]
              ]
            ]
            11 => array:3 [
              "identificador" => "bib0060"
              "etiqueta" => "12&#46;"
              "referencia" => array:1 [
                0 => array:2 [
                  "contribucion" => array:1 [
                    0 => array:2 [
                      "titulo" => "Primary pulmonary hypertension"
                      "autores" => array:1 [
                        0 => array:2 [
                          "etal" => false
                          "autores" => array:3 [
                            0 => "G&#46; Walcott"
                            1 => "H&#46;B&#46; Burchell"
                            2 => "A&#46;L&#46; Brown"
                          ]
                        ]
                      ]
                    ]
                  ]
                  "host" => array:1 [
                    0 => array:1 [
                      "Revista" => array:5 [
                        "tituloSerie" => "Am J&#46; Med&#46;"
                        "fecha" => "1970"
                        "volumen" => "49"
                        "paginaInicial" => "70"
                        "link" => array:1 [
                          0 => array:2 [
                            "url" => "https://www.ncbi.nlm.nih.gov/pubmed/4194011"
                            "web" => "Medline"
                          ]
                        ]
                      ]
                    ]
                  ]
                ]
              ]
            ]
            12 => array:3 [
              "identificador" => "bib0065"
              "etiqueta" => "13&#46;"
              "referencia" => array:1 [
                0 => array:2 [
                  "contribucion" => array:1 [
                    0 => array:2 [
                      "titulo" => "Pulmo nary&#8217; arterial pulsus alternans secundary to primary pulmonary hypertension"
                      "autores" => array:1 [
                        0 => array:2 [
                          "etal" => false
                          "autores" => array:5 [
                            0 => "B&#46;L&#46; Meyer"
                            1 => "D&#46;B&#46; Bogart"
                            2 => "J&#46;E&#46; Carley"
                            3 => "B&#46; Wong"
                            4 => "M&#46;I&#46; Dunn"
                          ]
                        ]
                      ]
                    ]
                  ]
                  "host" => array:1 [
                    0 => array:1 [
                      "Revista" => array:5 [
                        "tituloSerie" => "Chest&#46;"
                        "fecha" => "1976"
                        "volumen" => "70"
                        "paginaInicial" => "374"
                        "link" => array:1 [
                          0 => array:2 [
                            "url" => "https://www.ncbi.nlm.nih.gov/pubmed/133788"
                            "web" => "Medline"
                          ]
                        ]
                      ]
                    ]
                  ]
                ]
              ]
            ]
            13 => array:3 [
              "identificador" => "bib0070"
              "etiqueta" => "14&#46;"
              "referencia" => array:1 [
                0 => array:2 [
                  "contribucion" => array:1 [
                    0 => array:2 [
                      "titulo" => "Primary pulmonary hypertension&#46; Favorable ellect of isoproterenol"
                      "autores" => array:1 [
                        0 => array:2 [
                          "etal" => false
                          "autores" => array:5 [
                            0 => "V&#46;R&#46; Shettigar"
                            1 => "H&#46;N&#46; Hultgren"
                            2 => "M&#46; Specter"
                            3 => "R&#46; Martin"
                            4 => "H&#46; Davies"
                          ]
                        ]
                      ]
                    ]
                  ]
                  "host" => array:1 [
                    0 => array:2 [
                      "doi" => "10.1056/NEJM197612162952506"
                      "Revista" => array:5 [
                        "tituloSerie" => "N&#46; Engl&#46; J&#46; Med&#46;"
                        "fecha" => "1976"
                        "volumen" => "295"
                        "paginaInicial" => "1414"
                        "link" => array:1 [
                          0 => array:2 [
                            "url" => "https://www.ncbi.nlm.nih.gov/pubmed/980096"
                            "web" => "Medline"
                          ]
                        ]
                      ]
                    ]
                  ]
                ]
              ]
            ]
            14 => array:3 [
              "identificador" => "bib0075"
              "etiqueta" => "15&#46;"
              "referencia" => array:1 [
                0 => array:2 [
                  "contribucion" => array:1 [
                    0 => array:2 [
                      "titulo" => "Abnormal fybrinolisis in familial pulmonary hypertension"
                      "autores" => array:1 [
                        0 => array:2 [
                          "etal" => false
                          "autores" => array:3 [
                            0 => "T&#46;V&#46; Inglesgy"
                            1 => "J&#46;W&#46; Singer"
                            2 => "D&#46;S&#46; Cordon"
                          ]
                        ]
                      ]
                    ]
                  ]
                  "host" => array:1 [
                    0 => array:1 [
                      "Revista" => array:5 [
                        "tituloSerie" => "Am&#46; J&#46; Med"
                        "fecha" => "1973"
                        "volumen" => "55"
                        "paginaInicial" => "5"
                        "link" => array:1 [
                          0 => array:2 [
                            "url" => "https://www.ncbi.nlm.nih.gov/pubmed/4715931"
                            "web" => "Medline"
                          ]
                        ]
                      ]
                    ]
                  ]
                ]
              ]
            ]
            15 => array:3 [
              "identificador" => "bib0080"
              "etiqueta" => "16&#46;"
              "referencia" => array:1 [
                0 => array:2 [
                  "contribucion" => array:1 [
                    0 => array:2 [
                      "titulo" => "Pulmonary hypertension in the crest syndrome variant of profressive systemic sclerosis &#40;Sclerodenna&#41;"
                      "autores" => array:1 [
                        0 => array:2 [
                          "etal" => false
                          "autores" => array:4 [
                            0 => "R&#46; Salerni"
                            1 => "G&#46;P&#46; Rodnan"
                            2 => "D&#46;F&#46; Leon"
                            3 => "J&#46;A&#46; Shaver"
                          ]
                        ]
                      ]
                    ]
                  ]
                  "host" => array:1 [
                    0 => array:1 [
                      "Revista" => array:4 [
                        "tituloSerie" => "Ann&#46; Intem&#46; Med&#46;"
                        "fecha" => "1977"
                        "volumen" => "86"
                        "paginaInicial" => "394"
                      ]
                    ]
                  ]
                ]
              ]
            ]
            16 => array:3 [
              "identificador" => "bib0085"
              "etiqueta" => "17&#46;"
              "referencia" => array:1 [
                0 => array:2 [
                  "contribucion" => array:1 [
                    0 => array:2 [
                      "titulo" => "Case records o&#237; the Massachusetts general hospital&#46; Weekly dinicopathological exercises"
                      "autores" => array:1 [
                        0 => array:2 [
                          "etal" => false
                          "autores" => array:2 [
                            0 => "B&#46; Castleman"
                            1 => "B&#46;U&#46; Mc Neely"
                          ]
                        ]
                      ]
                    ]
                  ]
                  "host" => array:1 [
                    0 => array:2 [
                      "doi" => "10.1056/NEJM197201132860211"
                      "Revista" => array:5 [
                        "tituloSerie" => "N&#46; Engl&#46; J&#46; Med&#46;"
                        "fecha" => "1972"
                        "volumen" => "286"
                        "paginaInicial" => "91"
                        "link" => array:1 [
                          0 => array:2 [
                            "url" => "https://www.ncbi.nlm.nih.gov/pubmed/5006883"
                            "web" => "Medline"
                          ]
                        ]
                      ]
                    ]
                  ]
                ]
              ]
            ]
            17 => array:3 [
              "identificador" => "bib0090"
              "etiqueta" => "18&#46;"
              "referencia" => array:1 [
                0 => array:2 [
                  "contribucion" => array:1 [
                    0 => array:2 [
                      "titulo" => "Pathologic observations in systemic sclerosis &#40;Scleroderma&#41;&#46; A study of fifty-eight autopsy cases and fiftyeight matched Controls"
                      "autores" => array:1 [
                        0 => array:2 [
                          "etal" => false
                          "autores" => array:4 [
                            0 => "W&#46;A&#46; D&#8217;Angelo"
                            1 => "J&#46;F&#46; Fries"
                            2 => "A&#46;T&#46; Mase"
                            3 => "L&#46;E&#46; Shulman"
                          ]
                        ]
                      ]
                    ]
                  ]
                  "host" => array:1 [
                    0 => array:1 [
                      "Revista" => array:5 [
                        "tituloSerie" => "Am&#46; J&#46; Med&#46;"
                        "fecha" => "1969"
                        "volumen" => "46"
                        "paginaInicial" => "428"
                        "link" => array:1 [
                          0 => array:2 [
                            "url" => "https://www.ncbi.nlm.nih.gov/pubmed/5780367"
                            "web" => "Medline"
                          ]
                        ]
                      ]
                    ]
                  ]
                ]
              ]
            ]
            18 => array:3 [
              "identificador" => "bib0095"
              "etiqueta" => "19&#46;"
              "referencia" => array:1 [
                0 => array:2 [
                  "contribucion" => array:1 [
                    0 => array:2 [
                      "titulo" => "Vascular disease in Progressive systemic sclerosis &#40;Scleroderma&#41;"
                      "autores" => array:1 [
                        0 => array:2 [
                          "etal" => false
                          "autores" => array:2 [
                            0 => "W&#46;L&#46; Norton"
                            1 => "J&#46;M&#46; Nardo"
                          ]
                        ]
                      ]
                    ]
                  ]
                  "host" => array:1 [
                    0 => array:1 [
                      "Revista" => array:5 [
                        "tituloSerie" => "Ann Intern&#46; Med&#46;"
                        "fecha" => "1970"
                        "volumen" => "73"
                        "paginaInicial" => "317"
                        "link" => array:1 [
                          0 => array:2 [
                            "url" => "https://www.ncbi.nlm.nih.gov/pubmed/4916764"
                            "web" => "Medline"
                          ]
                        ]
                      ]
                    ]
                  ]
                ]
              ]
            ]
            19 => array:3 [
              "identificador" => "bib0100"
              "etiqueta" => "20&#46;"
              "referencia" => array:1 [
                0 => array:2 [
                  "contribucion" => array:1 [
                    0 => array:2 [
                      "titulo" => "The lung in scleroderma"
                      "autores" => array:1 [
                        0 => array:2 [
                          "etal" => false
                          "autores" => array:3 [
                            0 => "A&#46;L&#46; Weaver"
                            1 => "M&#46;B&#46; Civertie"
                            2 => "J&#46;L&#46; Titus"
                          ]
                        ]
                      ]
                    ]
                  ]
                  "host" => array:1 [
                    0 => array:1 [
                      "Revista" => array:5 [
                        "tituloSerie" => "Mayo Clin&#46; Proc&#46;"
                        "fecha" => "1967"
                        "volumen" => "42"
                        "paginaInicial" => "754"
                        "link" => array:1 [
                          0 => array:2 [
                            "url" => "https://www.ncbi.nlm.nih.gov/pubmed/4861356"
                            "web" => "Medline"
                          ]
                        ]
                      ]
                    ]
                  ]
                ]
              ]
            ]
          ]
        ]
      ]
    ]
  ]
  "idiomaDefecto" => "es"
  "url" => "/03002896/0000001400000003/v1_201509151322/S0300289615326156/v1_201509151322/es/main.assets"
  "Apartado" => array:4 [
    "identificador" => "9217"
    "tipo" => "SECCION"
    "es" => array:2 [
      "titulo" => "Notas cl&#237;nicas"
      "idiomaDefecto" => true
    ]
    "idiomaDefecto" => "es"
  ]
  "PDF" => "https://static.elsevier.es/multimedia/03002896/0000001400000003/v1_201509151322/S0300289615326156/v1_201509151322/es/main.pdf?idApp=UINPBA00003Z&text.app=https://archbronconeumol.org/"
  "EPUB" => "https://multimedia.elsevier.es/PublicationsMultimediaV1/item/epub/S0300289615326156?idApp=UINPBA00003Z"
]
Share
Journal Information
Vol. 14. Issue 3.
Pages 128-131 (July - September 1978)
Share
Share
Download PDF
More article options
Vol. 14. Issue 3.
Pages 128-131 (July - September 1978)
Full text access
Hipertension arterial pulmonar por sindrome crest
Pulmonary arterial hypertension by crest's syndrome
Visits
5471
J. Menéndez del Campo*, J.L. Carretero Sastre**, A. Ribas Barceló***, J.A. Mosquera Pestaña****
* Médico Adjunto al Servicio de Neumología. (I.N.S.). Instituto Nacional de Silicosis. Hospital General de Asturias. Oviedo
** Jefe Clínico Servido de Neumología (I.N.S.). Instituto Nacional de Silicosis. Hospital General de Asturias. Oviedo
*** Jeté del Servicio de Anatomía Patoiógéca (H.G.A.) Instituto Nacional de Silicosis. Hospital General de Asturias. Oviedo
**** Jefe del Servicio de Neumología (I.N.S.). Instituto Nacional de Silicosis. Hospital General de Asturias. Oviedo
This item has received
Article information
Resumen

Se presenta 1 paciente de 52 años con disnea progresiva de 4 años deevolución, clínica recidivante de fallo cardiaco derecho, telangiectasias, esclerodactilica y Raynaud bilateral.

Sus volúmenes pulmonares, resis tencias al flujo, compliance stática y DLCO eran normales.

Electrocardiograma y Vectocardiograma mostraba hipertrofia de ventrículo derecho. El cateterismo derecho e izquierdo mostró hipertensión pulmonar severa con presión en cuña normal y sin patología del corazón izquierdo. La angiografía pulmonar descartó tromboembolismo de grandes troncos arteriales.

La biopsia pulmonar abierta mostró moderada fibrosis intesticial y, sobre todo, acentuadas lesiones en la íntima de las arterias de mediano y pequeño calibre.

El diagnóstico etiopatogénico de la hipertensión pulmonar es difícil y exige medidas diagnósticas agresivas para separar las distintas entidades que lo producen y especialmente tromboembolismo pulmonar de pequeños vasos.

Calcinosis, Raynaud, esclerodactilia, afectación de esófago y telangiectasias (síndrome de CREST o CRST), son formas menores de esclerosis sisténtica y se han considerado de pronostico benigno.

Este paciente, junto a otros 13 descritos en la literatura son portadores de una hipertensión pulmonar por lesión vascular, poniendo en tela de juicio la benignidad del proceso.

Summary

The authors present the case of a 52-year-old patient with progressive dyspnea with a 4 year evolution, dinical relapse of right cardiac failure, telangiectasia, sclerodactylia and bilateral Raynaud.

His pulmonary volumes, resistance to flow, static compliance and DLCO were normal.

The electrocardiogram and vectora rdiogram showed hypertrophy of the right ventride. Right and left catheterism showed severe pulmonary hypertension with pressure in normal wedge and without pathology of the left heart. Pulmonary angiography discarted thrombo-embolism of large arterial trunks.

Open pulmonary biopsy showed moderated interstitial fibrosis and, above all, acentuated lesions in the intima of the arteries of medium and small caliber.

Full text is only aviable in PDF
Bibliografia
[1.]
Editorial Pulmonary veno-occlusive disease.
Brit. Med. J., 3 (1972), pp. 369
[2.]
E.N. Schachter, J.W. Smith, G.S. Cohen.
Pulmonary granulomas in a patient with pulmonary veno-occlusive disease.
Chest, 67 (1975), pp. 487
[3.]
J.E. Sanderson, S.G. Spiro, A.T. Hendry, M. Turner-Warwich.
A case of pulmonary veno-occlusive disease responding to treatnrent with azathioprime.
Thorax, 32 (1977), pp. 140
[4.]
D. Heath, J. Shaba, A. Williams.
A pulmonary hypertension producing plant from tanzania.
Thorax., 30 (1975), pp. 399
[5.]
H. Herzog, J. Widimsky.
Pulmonary hypertension.
S. Karger, (1975), pp. Pag55
[6.]
D.F. Bohr.
The pulmonary hypoxic response: State of the field.
Chest, 71 (1977), pp. 2
[7.]
M. Irene Ferrer.
Cor pulmonale (Pulmonary heart disease) present-day status.
Amer. Heart. Jour., 89 (1975), pp. 657
[8.]
G.V. Sharma, A.A. Sasahara, K.M. Mcintyre.
Pulmonary embolism: the great imitator D.M, (1976),
[9.]
K.M. Moser.
Pulmonary embolism.
Am. Rev. Resp. Dis., 115 (1977), pp. 829
[10.]
C.L. Christian, J.S. Sergent.
Vasculitis syndromes: Clinical and experimental models.
Am. Heart. Jour., 89 (1975), pp. 657
[11.]
J.M. Kay, S. Banik.
Unexplained pulmonary hypertension with pulmonary arteritis in rheumatoid disease.
Brit. J. Dis. Chest., 71 (1977), pp. 53
[12.]
G. Walcott, H.B. Burchell, A.L. Brown.
Primary pulmonary hypertension.
Am J. Med., 49 (1970), pp. 70
[13.]
B.L. Meyer, D.B. Bogart, J.E. Carley, B. Wong, M.I. Dunn.
Pulmo nary’ arterial pulsus alternans secundary to primary pulmonary hypertension.
Chest., 70 (1976), pp. 374
[14.]
V.R. Shettigar, H.N. Hultgren, M. Specter, R. Martin, H. Davies.
Primary pulmonary hypertension. Favorable ellect of isoproterenol.
N. Engl. J. Med., 295 (1976), pp. 1414
[15.]
T.V. Inglesgy, J.W. Singer, D.S. Cordon.
Abnormal fybrinolisis in familial pulmonary hypertension.
Am. J. Med, 55 (1973), pp. 5
[16.]
R. Salerni, G.P. Rodnan, D.F. Leon, J.A. Shaver.
Pulmonary hypertension in the crest syndrome variant of profressive systemic sclerosis (Sclerodenna).
Ann. Intem. Med., 86 (1977), pp. 394
[17.]
B. Castleman, B.U. Mc Neely.
Case records oí the Massachusetts general hospital. Weekly dinicopathological exercises.
N. Engl. J. Med., 286 (1972), pp. 91
[18.]
W.A. D’Angelo, J.F. Fries, A.T. Mase, L.E. Shulman.
Pathologic observations in systemic sclerosis (Scleroderma). A study of fifty-eight autopsy cases and fiftyeight matched Controls.
Am. J. Med., 46 (1969), pp. 428
[19.]
W.L. Norton, J.M. Nardo.
Vascular disease in Progressive systemic sclerosis (Scleroderma).
Ann Intern. Med., 73 (1970), pp. 317
[20.]
A.L. Weaver, M.B. Civertie, J.L. Titus.
The lung in scleroderma.
Mayo Clin. Proc., 42 (1967), pp. 754
Copyright © 1978. Sociedad Española de Neumología y Cirugía Torácica
Archivos de Bronconeumología
Article options
Tools

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