RESUMEN
A aspergilose broncopulmonar alérgica é uma doença pulmonar que ocorre em pacientes com asma ou fibrose cística, desencadeada pela reação de hipersensibilidade à presença do fungo Aspergilus fumigatus nas vias aéreas. Relatamos aqui um caso em que uma paciente com quadro clínico sugestivo de asma apresentou critérios clínicos, laboratoriais e radiológicos compatíveis com o diagnóstico de aspergilose broncopulmonar alérgica. A importância de tais achados deve-se ao fato de que quanto mais precocemente for feito o diagnóstico, menores serão os riscos de agravamento do quadro respiratório e de aparecimento de fibrose.
Allergic bronchopulmonary aspergillosis is a lung disease occurring in patients with asthma or cystic fibrosis, triggered by a hypersensitivity reaction to the presence of Aspergillus fumigatus in the airways. We report herein the case of a patient presenting a clinical profile suggestive of asthma and meeting the clinical, laboratory testing and radiological criteria for a diagnosis of allergic bronchopulmonary aspergillosis. The importance of such findings is that early diagnosis can reduce the risk of respiratory exacerbations and fibrosis.
Asunto(s)
Adulto , Femenino , Humanos , Albuterol/uso terapéutico , Aspergilosis Broncopulmonar Alérgica/diagnóstico , Aspergillus fumigatus/inmunología , Broncodilatadores/uso terapéutico , Prednisolona/uso terapéutico , Aspergilosis Broncopulmonar Alérgica/tratamiento farmacológico , Inmunoglobulina E/inmunología , Tomografía Computarizada por Rayos XRESUMEN
In order to assess the relationship between the physsical fitness of asthmatics and the clinical expression of the underlying disease, the authors studied 39 physically active children with moderate to severe but stable asthma.The patients (25 boys and 14 girls, aged between 9 and 16 years) were submitted to clinical evaluation; spirometry before and after bronchodilator (BD); maximal cardiopulmonary exercise test in cycle ergometer with breath-by-breath analysis of ventilatory and gas exchange variables; and, on a separate day, an exercise challenge test. s expected by the clinical stability, FEV1 post-BD was in the normaal range in most of the children (mean ñ SD= 93.8 ñ 13.7por cento predicted). Maximal oxygen uptake (VO2max) was higher thann the lower 95por cento confidence interval in 31/39 children; and in 29/39, the oxygen uptake at the anaerobic threshold (VO2AT) showed values above the lower limit of normality.