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- ItemAcesso aberto (Open Access)Doenças granulomatosas ocupacionais(Sociedade Brasileira de Pneumologia e Tisiologia, 2006-05-01) Bagatin, Ericson; Pereira, Carlos Alberto De Costa [UNIFESP]; Afiune, Jorge Barros; Universidade Estadual de Campinas (UNICAMP); Universidade Federal de São Paulo (UNIFESP); Instituto Clemente FerreiraA variety of diseases are encompassed in the didactic denomination of granulomatous diseases of probable occupational etiology. As well as presenting similar clinical aspects, such diseases are characterized by certain common traits: formation of granulomas; systemic and respiratory manifestations; environmental or occupational exposure to organic or inorganic agents; and T lymphocyte involvement in the pathogenesis. Included in this category are hypersensitivity pneumonitis, mycobacteriosis (all forms) and sarcoidosis, as well as beryllium disease and other lung diseases caused by exposure to heavy metals. In order to highlight the risk of developing one of these diseases as a result of environmental or occupational exposure to etiologic agents, we address aspects related to epidemiology, pathogenesis and evaluation of exposure of these diseases, as well as those related to diagnostic criteria, prevention and control. We have given special emphasis to groups of individuals considered to be at high risk for developing these diseases, as well as to the need for health care professionals to remain aware of the potential occupational etiology of such diseases, a decisive factor in devising effective measures of prevention and epidemiological surveillance.
- ItemAcesso aberto (Open Access)Pleuroparenchymal fibroelastosis: report of two cases in Brazil(Soc Brasileira Pneumologia Tisiologia, 2017) Gomes, Paula Silva [UNIFESP]; Shiang, Christina [UNIFESP]; Szarf, Gilberto [UNIFESP]; Coletta, Ester Nei Aparecida Martins [UNIFESP]; Pereira, Carlos Alberto de Castro [UNIFESP]Pleuroparenchymal fibroelastosis (PPFE) is a rare lung disease. It can be idiopathic or associated with any one of various conditions. To our knowledge, this is the first report of two cases of PPFE in Brazil. Our first patient presented with pleural and subpleural fibrosis in the upper lobes; a spiculated nodule in the left upper lobe; and a mild reticular pattern in the lower lobes. Surgical lung biopsy revealed PPFE in the upper lobes, including the nodule, and unclassified interstitial pneumonia in the left lower lobe. Our second patient had a history of exposure to domestic birds, indicating a risk of hypersensitivity pneumonitis, and presented with advanced lung disease, predominantly in the upper lobes, together with subpleural fibrosis.That patient underwent lung transplantation. In the explant specimen, PPFE and granulomas were identified, suggesting hypersensitivity pneumonitis as an associated cause.