Medicina (Buenos Aires)
versión On-line ISSN 1669-9106
ARCE, Santiago C.; MOLINARI, Luciana y DE VITO, Eduardo L.. Functional respiratory evolution in two patients with emphysema and pulmonary fibrosis. Medicina (B. Aires) [online]. 2009, vol.69, n.3, pp. 350-352. ISSN 1669-9106.
Combined pulmonary fibrosis and emphysema (CPFE) is a frequently under-diagnosed condition. Isolated pulmonary function tests (PFT) can give rise to misinterpretations. We have found no reports on these patients spirometric progression. We describe two cases of CPFE, showing long-term functional evolution to have a more accurate understanding of current spirometric values. The most relevant findings are: 1) spirometry with discrete functional alterations in the presence of a marked dyspnea and the need, in one patient, for chronic oxygen therapy; and 2) functional evolution reflecting "pseudonormalisation" of the initial obstructive spirometric pattern, possibly as a result of fibrosis development. A mild obstructive defect in a patient with chronic airflow limitation and marked impairment of his/her clinical status and functional class should alert on the possibility of associated pulmonary fibrosis. A computed tomography (CT) and previous PFTs will allow a better understanding of this condition.
Palabras clave : Pulmonary fibrosis; Pulmonary emphysema; Chronic obstructive pulmonary disease; Spirometry; Physiopathology.