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Pneumoconioses

  • Visão geral
  • Teoria
  • Diagnóstico
  • Tratamento
  • ACOMPANHAMENTO
  • Recursos
Última revisão: 9 Aug 2025
Última atualização: 17 Jan 2025

Resumo

Definição

History and exam

Key diagnostic factors

  • presença de fatores de risco
Full details

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)
Full details

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
Full details

Diagnostic investigations

1st investigations to order

  • radiografia torácica (póstero-anterior e lateral)
  • espirometria
  • teste da proliferação linfocitária induzida pelo berílio (BeLPT)
Full details

Investigations 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)
Full details

Treatment algorithm

ACUTE

proteinose alveolar secundária aguda (silicose aguda)

beriliose aguda

ONGOING

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.

Peer reviewer acknowledgements

BMJ Best Practice topics are updated on a rolling basis in line with developments in evidence and guidance. The peer reviewers listed here have reviewed the content at least once during the history of the topic.

Disclosures

Peer reviewer affiliations and disclosures pertain to the time of the review.

References

Our in-house evidence and editorial teams collaborate with international expert contributors and peer reviewers to ensure that we provide access to the most clinically relevant information possible.

Key articles

Balmes JR, Abraham JL, Dweik RA, et al. An official American Thoracic Society statement: diagnosis and management of beryllium sensitivity and chronic beryllium disease. Am J Respir Crit Care Med. 2014 Nov 15;190(10):e34-59.Full text  Abstract

American College of Radiology. ACR Appropriateness Criteria: occupational lung diseases. 2019 [internet publication].Full text

National Institute for Occupational Safety and Health. Health effects of occupational exposure to respirable crystalline silica. Apr 2002 [internet publication].Full text

International Labour Office. Guidelines for the use of the ILO international classification of radiographs of pneumoconioses, revised edition. 2022 [internet publication].Full text

US Occupational Safety and Health Administration (OSHA). Final rule to protect workers from occupational exposure to respirable crystalline silica. Appendix B to §1926.1153 construction standard - medical surveillance guidelines. Jun 2016 [internet publication].Full text

Reference articles

A full list of sources referenced in this topic is available to users with access to all of BMJ Best Practice.
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