Serviços Personalizados
Journal
Artigo
Indicadores
- Citado por SciELO
- Acessos
Links relacionados
- Similares em SciELO
Compartilhar
Revista Portuguesa de Pneumologia
versão impressa ISSN 0873-2159
Rev Port Pneumol v.12 n.5 Lisboa set. 2006
Doenças inflamatórias alérgicas das vias aéreas superiores e suas implicações na asma brônquica A propósito de um caso clínico
Allergic inflammatory diseases of the upper airways and their impact on asthma Following on from a case report
Ana L Fonseca 1
Ana M Arrobas 2
Resumo
Os autores apresentam o caso clínico de uma doente referenciada à consulta de alergologia respiratória por asma de difícil controlo. A investigação clínica conduziu à identificação de patologia inflamatória crónica das vias aéreas superiores de carácter grave, como factor de agravamento da asma brônquica. Após terapêutica, que no referido caso implicou abordagem cirúrgica dos seios perinasais, houve melhoria franca do controlo da asma. A propósito do caso, é efectuada uma revisão das principais patologias inflamatórias alérgicas das vias aéreas superiores (rinite, sinusite e polipose nasal) e abordadas as suas principais implicações no controlo da asma brônquica.
Palavras-chave: Asma brônquica, rinite alérgica, sinusite crónica, polipose nasal.
Abstract
The authors present a case report of a patient refered to physician for difficult-to-treat asthma. Clinical evaluation concluded that severe chronic inflammatory upper airway disease was an asthma worsening factor. Patient demonstrated improvement in asthma control, after surgery. In the context of the clinical study, the authors present a review of the most common allergic inflammatory diseases of the upper airways (allergic rhinitis, chronic sinusitis and nasal polyposis) and reflect on their impact on asthma.
Key-words: Asthma, allergic rhinitis, chronic sinusitis, nasal polyposis.
Texto completo disponível apenas em PDF.
Full text only available in PDF format.
Bibliografia
1. Nutku E, Toda M, Hamid Q A. Rhinitis, nasal polyposis and asthma: pathological aspects. In The Nose and Lung Diseases. European Respiratory Monograph. Vol. 6. Monograph 18. 2001; 9:115-32. [ Links ]
2. Global Strategy for Asthma Management and Prevention. National Institutes of Health. National Heart, Lung and Blood Institute. Revised 2005.
3. Bousquet J, Van Cauwenberge P, Khaltaev N. Allergic Rhinitis and its Impact on Asthma (ARIA). J Allergy Clin Immunol 2001; 108:5174-334.
4. Serrano C, Valero A, Picado C. Rhinitis and Asthma: One Airway, One Disease. Arch Bronconeumol 2005; 41(10):569-78.
5. Bénédicte Leynaert, Jean Bousquet, Catherine Neukirch, Renata Liard, Françoise Neukirch. Perennial Rhinitis: An independent risk factor for asthma in nonatopic subjects. J Allergy Clin Immunol 1999; 104:301-4.
6. Corren J, Adinoff A, Irvin C. Changes in bronchial responsiveness following nasal provocation allergen. J. Allergy Clin Immunol 1992; 89:611-8.
7. Schumaker M, Cora K, Taussig L. Pulmonary response to nasal-challenge testing of athopic subject with stable asthma. J Allergy Clin Immunol 1986; 78:30-5.
8. Littell N, Carlisle C, Millman R, Braman S. Changes in airway resistance following nasal provocation. Am Rev Resp Dis 1990; 141:580-3.
9. Togias A. Systemic immunologic and inflammatory aspects of allergic rhinitis. J Allergy Clin Immunol 2000; 106:S247-S50.
10. McCusker C, Chicoine M, Hamid D, Mazer B. Sitespecific sensitisation in a murine model of allergic rhinitis: role of the upper airway in lower airway disease. J. Allergy Clin Immunol 2002; 110:891-8.
11. Braunstahl GJ, Overbeek SE, KleinJan A, Prins JB, Hoogsteden HC, Fokkens WJ. Nasal allergen provocation induces adhesion molecule expression and tissue eosinophilia in upper and lower airways. J Allergy Clin Immunol 2001; 107:469-76.
12. Beeh KM, Beier J, Kornmann O, Meier C, Taeumer T, Buhl R. A single nasal allergen challenge increases induced sputum inflammatory markers in nonasthmatic subjects with seasonal allergic rhinitis: correlation with plasma interleukin-5. Clin Exp Allergy 2003; 33:475-82.
13. Braunstahl GJ, KleinJan A, Overbeek SE, Prins JB, Hoogsteden HC, Fokkens WJ. Segmental bronchial provocation induces nasal inflammation in allergic rhinitis patients. Am J Resp Crit Care Med 2000; 161:2051-7.
14. Braunstahl GJ, Overbeek SE, Fokkens WJ, KleinJan A, McEuen AR, Walls AF, et al. Segmental bronchoprovocation in allergic rhinitis affects mast cell and basophil numbers in nasal and bronchial mucosa. Am J Resp Crit Care Med 2001; 161:858-65.
15. Giovanni Passalacqua, Giorgio Ciprandi, Mercedes Pasquali, Laura Guerra, Giogio Canonica. An update on the asthma rhinitis link. Curr Opin Allergy Clin Immunol2004, 4:177-83.
16. Durham SR, Mackay S. Diseases of the nose. In Respiratory Medicine. Volume 2. Third Edition. 43:1035-47. Gibson GJ, Geddes DM, Costabel U, Sterk PJ, Corrin B, editors. Saunders.
17. John Weiner, Michael Abramson, Robert Puy. Intranasal corticosteroids versus oral Hreceptor antagonists in allergic rhinitis: systematic review of randomised controlled trials. BMJ 1998; 317:1624-9.
18. George Philip, Anjuli S. Nayak, William Berger, Francisque Leynadier, France Vrijens, S. Balachandra Dass, Theodore Reiss. The effect of montelukast on rhinitis symptoms in patients with asthma and seasonal allergic rhinitis. Curr Med Res 2004; 20(10):1549-58.
19. Stephan Durham, Stephan J. Till. Immunologic changes associated with allergen imunotherapy. J Allergy Clin Immunol 1998; 102:157-64.
20. Samantha M. Mucha, Fuad M. Baroody. Sinusitis Update. Curr Opin Allergy Clin Immunol 3:33-38.
21. Donald C. Lanza, David W. Kennedy. Adult rhinosinusitis defined. Otoryngol Head Neck Surg 1997; 117:S1-S7.
22. Carlos Lucas. Asma de difícil controlo. In Tratado de Pneumologia. Vol. I. 66.5: 909-920. Gomes MJ, Sotto-Mayor R (eds.). Sociedade Portuguesa de Pneumologia.
23. Bresiani M, Paradis L, Des Roches A, et al. Rhinosinusitis in severe asthma. J Allergy Clin Immunol 2001, 107:73-80.
24. Tosca A, Riccio AM, Marseglia GL, et al. Nasal endoscopy in asthmatic children: assessment of rhinosinusitis and adenoiditis incidence, correlations with cytology and microbiology. Clin Exp Allergy 2001; 31:609-15.
25. Brinke AT, Grootendorst DC, Schmidt JT, et al. Chronic sinusitis in severe asthma is related to sputum eosinophilia. J Allergy Clin Immunol 2002; 109:621-6.
26. Mensa J, Gatell JM, Azanza JR, Dominguez-Gil A, Garcia JE, Jiminez de Anta MT, Prats G. Guía de Terapêutica Antimicrobiana 2005; 3:407-10. Masson.
27. Cori Copilevitz, Raymond Slavin. Sinusitis and asthma. In Current Review of Asthma 2003; 7:61-5. Kaliner MA (ed.). Current Medicine.
28. Lavigne F, Cameron L, Renzi PM, et al. Intrasinus administration of topical budesonide to allergic patients with chronic sinusitis following surgery. Laryngoscope 2002; 112:858-64.
29. Rowe-Jones JM. The link between the nose and lung, perennial rhinitis and asthma-is it the same disease? Allergy 1997; 52 (Suppl 36): 20-8.
30. Dhong H-J, Jung YS, Chung SK, Choi DC. Effect of endoscopic sinus surgery on asthmatic patients with chronic rhinosinusitis. Otolaryngol Head Neck Surg 2001; 124:99-104.
31. Palmer JN, Conley DB, Dong RG, Ditto AM, Yamold PR, Kern RC. Efficacy of endoscopic surgery in the management of patients with asthma and chronic sinusitis. Am J Rhinol 2001; 15 (1):49-53.
32. Dunlop G, Scadding GK, Lund VJ. The effect of endoscopic sinus surgery asthma: management of patients with chronic rhinosinusitis, nasal polyposis, and asthma. Am J Rhinol 1999; 13:261-5.
33. Ruby Pawanker. Nasal polyposis: an update. Cur Opin Allergy Clin Immunol 2003; 3:1-6.
34. Pawliczak R, Lewandowska-Polak A, Kowalski ML. Pathogenesis of nasal polyps: an update. Curr Allergy Asthma Rep 2005 Nov; 5(6):463-71.
35. Bachert C, Van Zele T, Gevaert P, De Schrijver L, Van Cauwenberge P. Superantigens and nasal polyps. Curr Allergy Asthma Rep 2003; 3(6):523-31. Review.
36. Drake-Lee. Nasal polyps. Hosp Med 2004; 65(5):264-7.
37. Wynn R, Har-El G. Recorrence rates after endoscopic sinus surgery for massive sinus polyposis. Laryngoscope 2004; 114(5):811-3.
38. English GM. Nasal polypectomy and sinus surgery in patients with asthma and aspirin idiosyncrasy. Laryngoscope 1986, 96:374-80.
1 Interna do Complementar de Pneumologia
2 Assistente Hospitalar Graduada de Pneumologia
Serviço de Pneumologia. Director: Dr. Jorge Pires
Hospital Geral do Centro Hospitalar de Coimbra
Quinta dos Vales
Coimbra
Recebido para publicação/received for publication: 06.02.02
Aceite para publicação/accepted for publication: 06.05.18