Revisión crítica de articulo varón con eosinofilia, asma y aumento de IgE
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2016
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Universidad de Guayaquil. Facultad de Ciencias Químicas
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Antecedentes: La presencia de episodios de tos con expectoración verdosa, acompañados de disnea con un cuadro de asma que había empeorado hace un año atrás fue el motivo para que un paciente joven de 21 años de edad con diagnóstico de asma bronquial desde la infancia acudiera a consulta médica. Objetivo general: Establecer las causas que originan la eosinofilia, el asma y el aumento de la IgE para llegar a su respectivo diagnóstico. Metodología: Se aplicará la revisión crítica del artículo mediante criterios clínicos, radiológicos e inmunológicos recomendados por la literatura científica en un paciente diagnosticado con asma bronquial. Resultados: Durante el seguimiento que se le da al paciente se le realizan pruebas específicas serológicas y cutáneas para detectar Inmonuglobulinas específicas para Aapergillus dando resultados positivos así mismo se detectó un considerable aumento de la IgE total y específica y presencia de eosinofilia, con todos estos datos confirmados y tratándose de un paciente asmático y con bronquiectasias se pudo llegar al diagnóstico de Aspergilosis broncopulmonar alégica. Conclusiones: La mayoría de los pacientes con problemas de Aspergilosis presentan un sistema inmune deficiente razón por la cual son propensos a este tipo de afecciones, tratándose de una patología que no se presenta con mucha frecuencia en nuestro medio hay que tenerla en cuenta sobre todo en pacientes asmáticos o que tienen fibrosis quísticas especialmente si hay presencia de infiltraciones pulmonares y eosinofilia. El tratamiento a tiempo con antimicóticos evitara el progreso de la enfermedad.
Background: The presence of episodes of cough with greenish expectoration, accompanied by dyspnea with symptoms of asthma had worsened one year ago was the reason for a young patient of 21 years of age diagnosed with bronchial asthma since childhood acudiera to medical consultation. Objective: To establish the causes of eosinophilia, asthma and IgE increased to reach their respective diagnosis. Methodology: critical revision of the article is implemented through recommended by the scientific literature in a patient diagnosed with bronchial asthma clinical, radiological and immunological criteria. Results: During follow-up of the case that we are facing an asthmatic patient with peripheral blood eosinophilia, bronchiectasis and high total positive skin tests to Aspergillus, immunoglobulin E (IgE), specific immunoglobulin Aspergillus positive and immunoglobulin G (IgG) to positive Aspergillus, led to the diagnosis of allergic bronchopulmonary aspergillosis. Conclusions: Most patients with impaired aspergillosis have a deficient immune system why they are prone to these types of conditions, it is a rare disease that should be suspected in the presence of eosinophilia with pulmonary infiltrates in a patient carrying chronic asthma or cystic fibrosis. Early treatment with anti-fungal avoid the progression of the disease.
Background: The presence of episodes of cough with greenish expectoration, accompanied by dyspnea with symptoms of asthma had worsened one year ago was the reason for a young patient of 21 years of age diagnosed with bronchial asthma since childhood acudiera to medical consultation. Objective: To establish the causes of eosinophilia, asthma and IgE increased to reach their respective diagnosis. Methodology: critical revision of the article is implemented through recommended by the scientific literature in a patient diagnosed with bronchial asthma clinical, radiological and immunological criteria. Results: During follow-up of the case that we are facing an asthmatic patient with peripheral blood eosinophilia, bronchiectasis and high total positive skin tests to Aspergillus, immunoglobulin E (IgE), specific immunoglobulin Aspergillus positive and immunoglobulin G (IgG) to positive Aspergillus, led to the diagnosis of allergic bronchopulmonary aspergillosis. Conclusions: Most patients with impaired aspergillosis have a deficient immune system why they are prone to these types of conditions, it is a rare disease that should be suspected in the presence of eosinophilia with pulmonary infiltrates in a patient carrying chronic asthma or cystic fibrosis. Early treatment with anti-fungal avoid the progression of the disease.
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ASPERGILOSIS BRONCOPULMONAR ALÉRGICA, ASPERGILLUS FUMIGATUS