[Functional respiratory evolution in two patients with emphysema and pulmonary fibrosis].
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.
Arce
Santiago C
SC
Servicio de Neumonología y Laboratorio Pulmonar, Instituto de Investigaciones Médicas Alfredo Lanari, Buenos Aires, Argentina. arcesantiago@fibertel.com.ar
Molinari
Luciana
L
De Vito
Eduardo L
EL
D004417:Dyspnea / Q000209:etiology* / Q000503:physiopathology / Q000628:therapy; D006801:Humans; D008297:Male; D008875:Middle Aged; D010102:Oxygen Inhalation Therapy / Q000379:methods; D011656:Pulmonary Emphysema / Q000150:complications / Q000503:physiopathology* / Q000628:therapy; D011658:Pulmonary Fibrosis / Q000150:complications / Q000503:physiopathology* / Q000628:therapy; D013147:Spirometry; D014057:Tomography, X-Ray Computed