EPOC y neumonía

Huerta, Arturo; Domingo, Rebeca; Soler, Néstor

doi:10.1016/S0300-2896(10)70024-7

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La enfermedad pulmonar obstructiva crónica (EPOC) es una enfermedad crónica cuyo coste sanitario va aumentando alrededor del mundo. Otra enfermedad respiratoria que causa altos costes y morbilidad es la neumonía adquirida en la comunidad (NAC). El crecimiento constante de la población en el que ambas enfermedades confluyen (NAC y EPOC) hace que sea importante analizar las características clínicas. Se sabe que diversos factores celulares contribuyen a que la expresión clínica sea diferente, mientras unos harán clínica de agudización de EPOC, otros harán clínica de neumonía. El uso de nuevos biomarcadores (procalcitonina, proadrenomedulina y copeptina) ayudan a la diferenciación entre uno y otro cuadro clínico. Para poder disminuir la morbimortalidad es importante que se sigan las guías clínicas (en relación con el tratamiento antibiótico), que se deben prescribir a pacientes con NAC y EPOC. Para prevenirlo, también existen medidas como la vacuna antineumocócica, cuyo papel en la prevención de la NAC neumocócica debe estudiarse más. Esta revisión trata de aclarar algunos de los puntos anteriormente mencionados sobre estas dos enfermedades.

Palabras clave:

Neumonía

EPOC

Agudización

Abstract

Chronic obstructive pulmonary disease (COPD) is a chronic disease causing increasing healthcare costs worldwide. Another respiratory disease causing high costs and morbidity is community-acquired pneumonia (CAP). Because of the constant growth in the population with both diseases (CAP and COPD), analyzing their clinical characteristics is important. Several cellular factors are known to contribute to differences in clinical expression: some lead to COPD exacerbations while others lead to symptoms of pneumonia. The use of new biomarkers (procalcitonin, pro-adrenomedullin and copeptin) help to distinguish among these clinical pictures. To decrease morbidity and mortality, clinical guidelines on antibiotic therapy must be followed and this therapy should be prescribed to patients with CAP and COPD. There are also prevention measures such as the pneumococcal vaccine whose role in the prevention of pneumococcal CAP should be further studied. The present review aims to elucidate some of the above-mentioned issues.

Keywords:

Pneumonia

COPD

Exacterbation

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