Summary
Definition
History and exam
Key diagnostic factors
- presença de fatores de risco
Other diagnostic factors
- dispneia ao esforço
- tosse
- exame normal do tórax
- estertores na ausculta torácica
- constrição torácica e/ou sibilância
- expiração prolongada e sibilância na ausculta torácica
- áreas de macicez à percussão torácica
- cianose
- tórax em tonel
- hemoptise, febre ou sudorese noturna
- baqueteamento digital nas mãos e pés
- perda de peso
- sinais de artrite reumatoide ou de esclerodermia
- sinais de insuficiência renal (por exemplo, ganho de peso, edema, hipertensão)
Risk factors
- exposição ocupacional à sílica
- exposição ocupacional ao carvão
- exposição ocupacional ao berílio
- dose cumulativa elevada de sílica ou carvão inalado
- tabagismo
- ácido glutâmico na posição 69 da cadeia B1 da molécula HLA-DP (doença crônica por exposição ao berílio)
- dose cumulativa elevada de berílio inalado
Diagnostic tests
1st tests to order
- radiografia torácica (póstero-anterior e lateral)
- espirometria
- teste da proliferação linfocitária induzida pelo berílio (BeLPT)
Tests to consider
- biópsia e/ou lavagem broncoscópica
- tomografia computadorizada de alta resolução (TCAR) do tórax
- saturação do oxigênio
- gasometria arterial
- biópsia pulmonar
- teste para tuberculose (TB)
Treatment algorithm
proteinose alveolar secundária aguda (silicose aguda)
beriliose aguda
silicose crônica, pneumoconiose dos trabalhadores do carvão ou beriliose crônica
Contributors
Authors
Kenneth D. Rosenman, MD
Professor of Medicine
Division of Occupational and Environmental Medicine
Michigan State University
East Lansing
MI
Disclosures
KDR declares no competing interests.
Peer reviewers
Ware G. Kuschner, MD
Associate Professor of Medicine
Stanford University
Staff Physician
US Department of Veterans Affairs
Palo Alto Health Care System
Palo Alto
CA
Disclosures
WGK declares that he has no competing interests.
Harman Paintal, MBBS
Division of Pulmonary and Critical Care Medicine
Veterans Affairs Palo Alto Health Care System (VAPAHCS)
Palo Alto
CA
Disclosures
HP declares that he has no competing interests.
Francis Thien, MD, FRACP, FCCP
Professor
Box Hill Hospital and Monash University
Victoria
Australia
Disclosures
FT declares that he has no competing interests.
Edward L. Petsonk, MD
Professor of Medicine
Section of Pulmonary and Critical Care Medicine
West Virginia University School of Medicine
Morgantown
WV
Disclosures
ELP declares that he has no competing interests.
Christopher M. Barber, BM, BS, BMedSci, FRCP, MD, AFOM
Respiratory Consultant
Sheffield Teaching Hospitals NHS Foundation Trust
Sheffield
UK
Disclosures
CMB declares that he has no competing interests.
Carl J. Reynolds, MBBS, MRCP, BSc, MSc, PhD, DPMSA
Respiratory Consultant
Honorary Senior Clinical Lecturer
North Middlesex University Hospital
Imperial College London
UK
Disclosures
CJR declares that he has no competing interests.
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