30 setembro, 2010

DERRAME PLEURAL O QUE É ISSO?

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Bom gente trouxe algumas informações a respeito do derrame pleural...que segundo eu tenho lido é uma coisa bem comum em quem tem lupus...
A pleura é a serosa que reveste os pulmões e a cavidade torácica. Os derrames
pleurais – acúmulo de líquido entre as pleuras visceral e parietal – constituem a manifestação
clínica mais freqüente de doença pleural primária ou secundária. Os derrames decorrentes do
envolvimento pleural secundário a doenças torácicas ou sistêmicas são muito mais freqüentes do
que os causados por doença primária da pleura, e a sua abordagem diagnóstica faz parte da rotina
de um pneumologista e de várias outras especialidades médica
 Principais causas de derrame pleural
1. EXSUDATOS
- Neoplasia primária ou metastática
- Tuberculose pleural
- Pneumonias bacterianas
- Embolia pulmonar
- Pancreatite
- Pleurite urêmica
- Síndrome de Meigs
- Colagenoses (artrite reumatóide e lupus eritematoso
sistêmico)
2. TRANSUDATOS
- Insuficiência cardíaca congestiva
- Embolia pulmonar
- Síndrome nefrótica
- Cirrose hepática
- Desnutrição
- Enteropatia perdedora de proteínas
3. QUILOTÓRAX
- Rotura traumática do ducto torácico
- Obstrução ao retôrno venoso central (trombose
de grandes vasos)
- Obstrução do ducto torácico (linfomas, aneurisma
de aorta, tuberculose, filariose, fibrose mediastinal)
- Doenças do sistema vascular linfático (linfomas,
linfangiomatose, linfangioleiomiomatose)
4. DERRAME PLEURAL HEMORRÁGICO
- Traumatismo torácico
- Neoplasias
- Embolia pulmonar com ou sem infarto pulmonar
- Pancreatite
- Insuficiência cardíaca
- Síndrome de Dressler
(http://www.fmrp.usp.br/revista/1998/vol31n2/derrames_pleurais_fisiopatologia_diagnostico.pdf)


O derrame pleural é caracterizado pela acumulação de liquido em excesso entre as pleuras e constitui uma manifestação comum de comprometimento pleural tanto primário quanto secundário.
O derrame pleural não é uma doença, mas sim a manifestação de outras doenças. Se não tratado adequadamente, esta patologia pode levar o paciente à dispneia (falta grave de ar) e até à morte.
As doenças primitivas da pleura são raras, sendo predominante a sua origem por processos patológicos extra-pleurais. A etiologia dos derrames é múltipla, sendo útil a divisão dos derrames em transudatos e exsudatos, porque no caso de se tratar de um transudato restringe-se drasticamente o numero de diagnósticos possíveis
Fisiologicamente existe equilíbrio entre a entrada e saída de líquido na cavidade pleural; de modo a manter constante a quantidade e concentração proteica do fluído pleural. Os movimentos respiratórios, pela alternância da inspiração e expiração, facilitam a reabsorção do líquido e das partículas, assim como a sua progressão nos linfáticos(http://www.derramepleural.com/)

53 comentários:

  1. Olá.

    "descobri" há pouco tempo que tenho Lupus! :(
    fala-se em DERRAME! Alguém explica s tem apenas a ver com a pleura???
    Obrigada! Até breve!

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