Vol. 13. Núm. 64.
Páginas 3769-3780 (Octubre 2022)

Actualización
Neumonías intersticiales idiopáticas

Idiopathic interstitial pneumonias

D. Velasco-ÁlvarezabI. Jara AlonsoabJ. Rigual BobilloabA. Jaureguízar Oriolab
Doi : https://10.1016/j.med.2022.09.011
Opciones
Resumen

La fibrosis pulmonar idiopática tiene un cuadro clínico inespecífico e insidioso, siendo la enfermedad intersticial más frecuente y de peor pronóstico conocida, con una supervivencia de 2 a 5 años sin tratamiento. En el año 2018, las sociedades científicas actualizaron criterios diagnósticos, siendo la presencia del patrón de neumonía intersticial usual en la TCAR y/o la biopsia pulmonar determinante para establecer el diagnóstico. Dentro de las neumonías intersticiales idiopáticas, la más frecuente es la fibrosis pulmonar, pero existen otras entidades menos frecuentes como son la neumonía intersticial no específica (NINE), la bronquiolitis respiratoria asociada a enfermedad pulmonar intersticial difusa (BR-EPID) y neumonía intersticial descamativa (NID), estas dos últimas relacionadas con el consumo de tabaco. También las que se presentan de forma aguda o subaguda como la neumonía organizada criptogenética (NOC) y la neumonía intersticial aguda (NIA) y, finalmente, las menos frecuentes como la neumonía intersticial linfoide (NIL) y la fibroelastosis pleuroparenquimatosa idiopática (FEPPI).

Palabras clave
Fibrosis pulmonar
Clínica
Tomografía de tórax de alta resolución
Neumonía intersticial usual
Abstract

Idiopathic interstitial fibrosis has nonspecific, insidious clinical symptoms; it is the most common interstitial disease and has the worse known prognosis, with a survival without treatment of two to five years. In 2018, scientific societies updated the diagnostic criteria; the presence of a usual interstitial pneumonia pattern on an HRCT scan and/or a lung biopsy are decisive for establishing a diagnosis. Among idiopathic interstitial pneumonias, the most common is pulmonary fibrosis, but there are other less common entities such as nonspecific interstitial pneumonia (NSIP), respiratory bronchiolitis-associated diffuse interstitial lung disease (RB-DILD), and desquamative interstitial pneumonia (DIP); the latter two are related to tobacco use. There are also those which present in acute or subacute forms, such as cryptogenic organizing pneumonia (COP) and acute interstitial pneumonia (AIP). Lastly, there are the least common forms, such as lymphoid interstitial pneumonia (LIP) and idiopathic pleuroparenchymal fibroelastosis (IPPFE).

Keywords
Pulmonary fibrosis
Symptoms
High-resolution thoracic tomography
Usual interstitial pneumonia

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