%0 Journal Article
%T Insufici那ncia respirat車ria aguda causada por pneumonia em organiza  o secund芍ria 角 terapia antineopl芍sica para linfoma n o Hodgkin Acute respiratory failure caused by organizing pneumonia secondary to antineoplastic therapy for non-Hodgkin's lymphoma
%A Adriell Ramalho Santana
%A F芍bio Ferreira Amorim
%A Paulo Henrique Alves Soares
%A Edmilson Bastos de Moura
%J Revista Brasileira de Terapia Intensiva
%D 2012
%I Associa??o de Medicina Intensiva Brasileira
%X Doen as difusas do par那nquima pulmonar pertencem a um grupo de doen as de evolu  o geralmente subaguda ou cr nica, mas que podem determinar insufici那ncia respirat車ria aguda. Paciente masculino, 37 anos, em terapia para linfoma n o Hodgkin, admitido com tosse seca, febre, dispneia e insufici那ncia respirat車ria aguda hipox那mica. Iniciadas ventila  o mecanica e antibioticoterapia, por谷m houve evolu  o desfavor芍vel. Tomografia computadorizada de t車rax mostrava opacidades pulmonares em "vidro fosco" bilaterais. Devido ao paciente ter feito uso de tr那s drogas relacionadas 角 pneumonia em organiza  o (ciclofosfamida, doxorrubicina e rituximabe) e quadros cl赤nico e radiol車gico serem sugestivos, iniciou-se pulsoterapia com metilprednisolona com boa resposta. Pneumonia em organiza  o pode ser idiop芍tica ou associada a colagenoses, drogas e neoplasias, e geralmente responde bem a corticoterapia. O diagn車stico 谷 anatomopatol車gico, mas condi  es cl赤nicas do paciente n o permitiam a realiza  o de bi車psia pulmonar. Pneumonia em organiza  o deve ser diagn車stico diferencial em pacientes com aparente pneumonia de evolu  o desfavor芍vel ao tratamento antimicrobiano. Interstitial lung diseases belong to a group of diseases that typically exhibit a subacute or chronic progression but that may cause acute respiratory failure. The male patient, who was 37 years of age and undergoing therapy for non-Hodgkin's lymphoma, was admitted with cough, fever, dyspnea and acute hypoxemic respiratory failure. Mechanical ventilation and antibiotic therapy were initiated but were associated with unfavorable progression. Thoracic computed tomography showed bilateral pulmonary "ground glass" opacities. Methylprednisolone pulse therapy was initiated with satisfactory response because the patient had used three drugs related to organizing pneumonia (cyclophosphamide, doxorubicin and rituximab), and the clinical and radiological symptoms were suggestive. Organizing pneumonia may be idiopathic or linked to collagen diseases, drugs and cancer and usually responds to corticosteroid therapy. The diagnosis was anatomopathological, but the patient's clinical condition precluded performing a lung biopsy. Organizing pneumonia should be a differential diagnosis in patients with apparent pneumonia and a progression that is unfavorable to antimicrobial treatment.
%K Pneumonia em organiza  o criptog那nica
%K Insufici那ncia respirat車ria
%K Toxicidade de drogas
%K Doen as pulmonares intersticiais
%K Linfoma n o Hodgkin
%K Tomografia computadorizada por raios X
%K Relatos de casos
%K Cryptogenic organizing pneumonia
%K Respiratory insufficiency
%K Drug toxicity
%K Lung diseases
%K interstitial
%K Lymphoma
%K non-Hodgkin
%K Tomography
%K X-ray computed
%K Case reports
%U http://www.scielo.br/scielo.php?script=sci_arttext&pid=S0103-507X2012000400020