Utilidad de la biopsia transbronquial en el diagnostico de enfermedades pulmonares en pacientes VIH/SIDA

Abstract

Transbronchial biopsy is a useful tool in the diagnosis of a heterogeneous group of lung diseases. The aim of this study was to determine the etiology of pulmonary processes more frequent in the group of HIV / AIDS patient sin controlled Autonomous Institute of the Andes University Hospital during the period February to September2009. We performed an observational, analytical and descriptive epidemiological approach, clinical and pathological in a group of 39 patients with human immunodeficiency virus. Of these only 36 met the inclusion criteria for this study. Blood analyzes were made, immunological profile, imaging studies, bronchoalveolar lavage, bronchial brushing and transbronchial biopsy. The histological sections showed inflammatory response at different stages of evolution, diffuse alveolar damage and intra-alveolar edema. Diagnosis was made from a group of opportunistic diseases such as pneumocystosis, Histoplasmosis, Candida, and injury probably due to Herpes virus and Cytomegalovirus. It emphasizes the participation of more than a germ. In addition there was vasculitis, thrombi, areas of ischemic necrosis, interstitial fibrosis and findings suggestive of pulmonary hypertension. One of the patients showed undifferentiated epithelial malignancy neoplasm. The use of this technique allowed us to evaluate the presence of opportunistic infections and unusual neoplasms and findings suggestive of pulmonary hypertension. Its use is justified, before the need for an etiologic diagnosis and establish the indicated therapy.