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Signo de Schamroth reversible
Reversible Schamroth Sign
Alejandro Maiso, Luis Dominguez-Juncal, Pedro J. Marcos
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Servicio de Neumología, Instituto de Investigación Biomédica de A Coruña (INIBIC), Complejo Hospitalario Universitario de A Coruña (CHUAC), Sergas, Universidade da Coruña (UDC), A Coruña, España
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Múltiples nódulos milimétricos uniformes de distribución difusa, bilateral y aleatoria con predominio en los lóbulos superiores, sin distorsión del parénquima pulmonar. B. Masa de partes blandas circunferencial que presenta realce periférico con áreas de líquido atrapadas en su interior. La masa tiene un importante componente prevertebral con un pequeño componente epidural anterior que comprime mínimamente la médula, pero no asocia mielopatía compresiva. C. Extensa alteración de la morfología y señal de cuerpos vertebrales T8 y T9 con acuñamiento de ambos, desestructuración del disco y hundimiento de la plataforma superior de T9.</p>" ] ] ] "autores" => array:1 [ 0 => array:2 [ "autoresLista" => "Miguel Ariza-Prota, Ana Pando-Sandoval, Marta García-Clemente" "autores" => array:3 [ 0 => array:2 [ "nombre" => "Miguel" "apellidos" => "Ariza-Prota" ] 1 => array:2 [ "nombre" => "Ana" "apellidos" => "Pando-Sandoval" ] 2 => array:2 [ "nombre" => "Marta" "apellidos" => "García-Clemente" ] ] ] ] ] "idiomaDefecto" => "es" "Traduccion" => array:1 [ "en" => array:9 [ "pii" => "S1579212916000045" "doi" => "10.1016/j.arbr.2016.01.003" "estado" => "S300" "subdocumento" => "" "abierto" => array:3 [ "ES" => false "ES2" => false "LATM" => false ] "gratuito" => false "lecturas" => array:1 [ "total" => 0 ] "idiomaDefecto" => "en" "EPUB" => "https://multimedia.elsevier.es/PublicationsMultimediaV1/item/epub/S1579212916000045?idApp=UINPBA00003Z" ] ] "EPUB" => "https://multimedia.elsevier.es/PublicationsMultimediaV1/item/epub/S0300289615000915?idApp=UINPBA00003Z" "url" => "/03002896/0000005200000003/v1_201602260058/S0300289615000915/v1_201602260058/es/main.assets" ] "itemAnterior" => array:19 [ "pii" => "S0300289614004931" "issn" => "03002896" "doi" => "10.1016/j.arbres.2014.12.008" "estado" => "S300" "fechaPublicacion" => "2016-03-01" "aid" => "1110" "copyright" => "SEPAR" "documento" => "article" "crossmark" => 1 "subdocumento" => "sco" "cita" => "Arch Bronconeumol. 2016;52:166" "abierto" => array:3 [ "ES" => true "ES2" => true "LATM" => true ] "gratuito" => true "lecturas" => array:2 [ "total" => 2898 "formatos" => array:3 [ "EPUB" => 120 "HTML" => 2120 "PDF" => 658 ] ] "es" => array:11 [ "idiomaDefecto" => true "cabecera" => "<span class="elsevierStyleTextfn">Imagen clínica</span>" "titulo" => "Empiema bilateral secundario a una perforación esofágica espontánea" "tienePdf" => "es" "tieneTextoCompleto" => "es" "paginas" => array:1 [ 0 => array:1 [ "paginaInicial" => "166" ] ] "titulosAlternativos" => array:1 [ "en" => array:1 [ "titulo" => "Bilateral Empyema Due to Spontaneous Esophageal Perforation" ] ] "contieneTextoCompleto" => array:1 [ "es" => true ] "contienePdf" => array:1 [ "es" => true ] "resumenGrafico" => array:2 [ "original" => 0 "multimedia" => array:7 [ "identificador" => "fig0005" "etiqueta" => "Figura 1" "tipo" => "MULTIMEDIAFIGURA" "mostrarFloat" => true "mostrarDisplay" => false "figura" => array:1 [ 0 => array:4 [ "imagen" => "gr1.jpeg" "Alto" => 1270 "Ancho" => 1658 "Tamanyo" => 235759 ] ] "descripcion" => array:1 [ "es" => "<p id="spar0005" class="elsevierStyleSimplePara elsevierViewall">Tomografía pulmonar donde se encuentra derrame pleural bilateral con signo de neumomediastino, hay comunicación fistulosa del esófago al compartimento mediastinal posterior, acumulándose el contraste en la zona declive de ambos hemitórax.</p>" ] ] ] "autores" => array:1 [ 0 => array:2 [ "autoresLista" => "Luis Daniel Umezawa Makikado, César Augusto Noriega Rocca, Gonzalo Ernesto Gianella Malca" "autores" => array:3 [ 0 => array:2 [ "nombre" => "Luis Daniel" "apellidos" => "Umezawa Makikado" ] 1 => array:2 [ "nombre" => "César Augusto" "apellidos" => "Noriega Rocca" ] 2 => array:2 [ "nombre" => "Gonzalo Ernesto" "apellidos" => "Gianella Malca" ] ] ] ] ] "idiomaDefecto" => "es" "Traduccion" => array:1 [ "en" => array:9 [ "pii" => "S1579212916000033" "doi" => "10.1016/j.arbr.2016.01.002" "estado" => "S300" "subdocumento" => "" "abierto" => array:3 [ "ES" => false "ES2" => false "LATM" => false ] "gratuito" => false "lecturas" => array:1 [ "total" => 0 ] "idiomaDefecto" => "en" "EPUB" => "https://multimedia.elsevier.es/PublicationsMultimediaV1/item/epub/S1579212916000033?idApp=UINPBA00003Z" ] ] "EPUB" => "https://multimedia.elsevier.es/PublicationsMultimediaV1/item/epub/S0300289614004931?idApp=UINPBA00003Z" "url" => "/03002896/0000005200000003/v1_201602260058/S0300289614004931/v1_201602260058/es/main.assets" ] "es" => array:13 [ "idiomaDefecto" => true "cabecera" => "<span class="elsevierStyleTextfn">Imagen clínica</span>" "titulo" => "Signo de Schamroth reversible" "tieneTextoCompleto" => true "paginas" => array:1 [ 0 => array:1 [ "paginaInicial" => "167" ] ] "autores" => array:1 [ 0 => array:4 [ "autoresLista" => "Alejandro Maiso, Luis Dominguez-Juncal, Pedro J. Marcos" "autores" => array:3 [ 0 => array:2 [ "nombre" => "Alejandro" "apellidos" => "Maiso" ] 1 => array:2 [ "nombre" => "Luis" "apellidos" => "Dominguez-Juncal" ] 2 => array:4 [ "nombre" => "Pedro J." "apellidos" => "Marcos" "email" => array:1 [ 0 => "pedro.jorge.marcos.rodriguez@sergas.es" ] "referencia" => array:1 [ 0 => array:2 [ "etiqueta" => "<span class="elsevierStyleSup">*</span>" "identificador" => "cor0005" ] ] ] ] "afiliaciones" => array:1 [ 0 => array:2 [ "entidad" => "Servicio de Neumología, Instituto de Investigación Biomédica de A Coruña (INIBIC), Complejo Hospitalario Universitario de A Coruña (CHUAC), Sergas, Universidade da Coruña (UDC), A Coruña, España" "identificador" => "aff0005" ] ] "correspondencia" => array:1 [ 0 => array:3 [ "identificador" => "cor0005" "etiqueta" => "⁎" "correspondencia" => "Autor para correspondencia." ] ] ] ] "titulosAlternativos" => array:1 [ "en" => array:1 [ "titulo" => "Reversible Schamroth Sign" ] ] "resumenGrafico" => array:2 [ "original" => 0 "multimedia" => array:7 [ "identificador" => "fig0005" "etiqueta" => "Figura 1" "tipo" => "MULTIMEDIAFIGURA" "mostrarFloat" => true "mostrarDisplay" => false "figura" => array:1 [ 0 => array:4 [ "imagen" => "gr1.jpeg" "Alto" => 517 "Ancho" => 1301 "Tamanyo" => 92621 ] ] "descripcion" => array:1 [ "es" => "<p id="spar0005" class="elsevierStyleSimplePara elsevierViewall">A: Signo de Schamroth. B: Desaparición del signo de Schamroth tras un mes de tratamiento esteroideo.</p>" ] ] ] "textoCompleto" => "<span class="elsevierStyleSections"><p id="par0005" class="elsevierStylePara elsevierViewall">Mujer de 38 años que ingresa en el hospital por disnea progresiva de 6 meses de evolución. La exploración física realizada no mostraba alteraciones relevantes, excepto por la presencia de acropaquias incipientes en sus manos y una saturación basal de oxígeno del 93% en reposo. Una exploración más detallada de sus manos mostró la presencia del signo de Schamroth, que se caracteriza por la ausencia del espacio con forma de diamante que se forma entre las uñas de 2 dedos cuando se enfrentan en posición dorsal las falanges distales de un dedo de cada mano<a class="elsevierStyleCrossRef" href="#bib0010"><span class="elsevierStyleSup">1</span></a> (<a class="elsevierStyleCrossRef" href="#fig0005">fig. 1</a>A). La radiografía de tórax fue normal, y la tomografía computarizada de tórax mostraba unos sutiles infiltrados en vidrio deslustrado bilaterales. Se realizó una espirometría, que mostraba un patrón restrictivo (capacidad vital forzada del 46%), y una broncoscopia con lavado broncoalveolar, donde destacaba la presencia de un 50% de linfocitos. Tomando como base estos hallazgos se realizó una biopsia pulmonar mediante videotoracoscopia por puerto único. Los resultados fueron compatibles con neumonía intersticial no específica, y se inició tratamiento con esteroides orales. Un mes más tarde, los síntomas respiratorios y la función pulmonar habían mejorado significativamente, pero además detectamos una normalización en la exploración de los dedos de las manos, con desaparición completa del signo de Schamroth (<a class="elsevierStyleCrossRef" href="#fig0005">fig. 1</a>B).</p><elsevierMultimedia ident="fig0005"></elsevierMultimedia></span>" "pdfFichero" => "main.pdf" "tienePdf" => true "multimedia" => array:1 [ 0 => array:7 [ "identificador" => "fig0005" "etiqueta" => "Figura 1" "tipo" => "MULTIMEDIAFIGURA" "mostrarFloat" => true "mostrarDisplay" => false "figura" => array:1 [ 0 => array:4 [ "imagen" => "gr1.jpeg" "Alto" => 517 "Ancho" => 1301 "Tamanyo" => 92621 ] ] "descripcion" => array:1 [ "es" => "<p id="spar0005" class="elsevierStyleSimplePara elsevierViewall">A: Signo de Schamroth. B: Desaparición del signo de Schamroth tras un mes de tratamiento esteroideo.</p>" ] ] ] "bibliografia" => array:2 [ "titulo" => "Bibliografía" "seccion" => array:1 [ 0 => array:2 [ "identificador" => "bibs0005" "bibliografiaReferencia" => array:1 [ 0 => array:3 [ "identificador" => "bib0010" "etiqueta" => "1" "referencia" => array:1 [ 0 => array:2 [ "contribucion" => array:1 [ 0 => array:2 [ "titulo" => "Validity and reliability of the Schamroth sign for the diagnosis of clubbing" "autores" => array:1 [ 0 => array:2 [ "etal" => false "autores" => array:5 [ 0 => "A. Pallarés-Sanmartín" 1 => "V. Leiro-Fernández" 2 => "T.L. Cebreiro" 3 => "M. Botana-Rial" 4 => "A. Fernández-Villar" ] ] ] ] ] "host" => array:1 [ 0 => array:2 [ "doi" => "10.1001/jama.2010.935" "Revista" => array:6 [ "tituloSerie" => "JAMA." "fecha" => "2010" "volumen" => "304" "paginaInicial" => "159" "paginaFinal" => "161" "link" => array:1 [ 0 => array:2 [ "url" => "https://www.ncbi.nlm.nih.gov/pubmed/20628128" "web" => "Medline" ] ] ] ] ] ] ] ] ] ] ] ] ] "idiomaDefecto" => "es" "url" => "/03002896/0000005200000003/v1_201602260058/S0300289614004906/v1_201602260058/es/main.assets" "Apartado" => array:4 [ "identificador" => "45361" "tipo" => "SECCION" "es" => array:2 [ "titulo" => "Imagen clínica" "idiomaDefecto" => true ] "idiomaDefecto" => "es" ] "PDF" => "https://static.elsevier.es/multimedia/03002896/0000005200000003/v1_201602260058/S0300289614004906/v1_201602260058/es/main.pdf?idApp=UINPBA00003Z&text.app=https://www.archbronconeumol.org/" "EPUB" => "https://multimedia.elsevier.es/PublicationsMultimediaV1/item/epub/S0300289614004906?idApp=UINPBA00003Z" ]
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