Enfermedad pulmonar venooclusiva en una mujer jardinera / No disponible

La enfermedad pulmonar venooclusiva (EPVO) es una forma infrecuente de hipertensión arterial pulmonar, con un pronóstico sombrío. El diagnóstico suele ser tardío y el único tratamiento curativo en la actualidad es el trasplante pulmonar. Presentamos el caso de una mujer jardinera de 51 años, cuyo diagnóstico se obtuvo por biopsia pulmonar abierta realizada previamente a su fallecimiento. Si bien existen casos reportados de enfermedad pulmonar venooclusiva hepática secundaria a agentes tóxicos presentes en la naturaleza, como el alcaloide pirrolizidina, hasta el momento no se han relacionado con la enfermedad a nivel pulmonar (AU)

Pulmonary veno-occlusive disease (PVOD) is a subgroup of pulmonary arterial hypertension with a poor prognosis. The diagnosis is usually delay and treatment options other lung transplation are unfortunately limited. We report the case of gardener 51 year old woman diagnosed with PVOD by open lung biopsy before her death. There are any cases report of hepatic veno-occlusive disease due to nature, like “pyrrolizidine alkaloid” exposure, but this is not proven to PVOD (AU)

[Role of bronchoalveolar lavage and transbronchial biopsy in the diagnosis of pneumonia in patients with organ transplantation]. / Papel del lavado broncoalveolar y la biopsia transbronquial en el diagnóstico de neumonías en pacientes portadores de trasplante de órganos.

Pneumonia in patients with organ transplantation constitutes a very frequent cause of mortality, as a result precocious aetiologic diagnosis is indispensable. The bronchoscopic techniques, bronchoalveolar lavage (BAL) and transbronchial biopsy (TBB), constitute fundamental procedures for these diagnoses. We begin this study with the aim of evaluating the profitability obtained with these procedures. 36 bronchoscopies were performed on 29 patients with organ transplantation, in all of them we realized BAL and in 20 TBB. We confirm the presence of pneumonia in 30 (in 15 of them we had performed TBB), the BAL was diagnostic in 20 cases (66.6%) and the TBB in 7 (46.6%). With both, BAL and TBB, we obtained a sensitivity of 80% and a specificity of 75%. We isolated 10 bacteria, 8 Citomegalovirus (CMV), 6 Pneumocystis carinii and 2 Aspergillus fumigatus. The BAL and the TBB contributed significantly in the aetiologic diagnosis of pneumonia in patients with organ transplantation, consequently we consider them basic tools in the management of these infections.

[Bronchiolitis obliterans with idiopathic organized pneumonia. Apropos of 4 cases]. / Bronquiolitis obliterante con neumonía organizada idiopática. A propósito de cuatro casos.

We report 4 cases of idiopathic bronchiolitis obliterans with organizing pneumonia. With this motive, we asses the clinical and radiologic features, lung function tests and response to treatment of our cases. Our findings, in general, are coincident with other authors. It's an entity with nonspecific respiratory symptoms that one must suspect in presence of alveolar patchy opacities on chest roentgenogram that do not respond to antibiotics. The diagnosis is based on histopathologic findings with lung biopsy and the treatment on corticosteroids, with favorable evolution in the majority of the cases.