Hegazi Mohamed Osama, El Sayed Amin, El Ghoussein Hussam
Department of Medicine, Al Adan Hospital, Ahmadi, Kuwait.
Respirology. 2008 Nov;13(6):923-5. doi: 10.1111/j.1440-1843.2008.01353.x.
Pulmonary hypertension in adults with hyperthyroidism is increasingly being reported. Although the mechanism is uncertain, the reversal of pulmonary hypertension following restoration to an euthyroid state supports a causal relationship. This case report is of a 43-year-old woman who presented with Graves disease and right ventricular failure. Echocardiography showed severe pulmonary hypertension, moderate to severe tricuspid regurgitation, normal left heart function and a negative bubble contrast study. Carbimazole therapy was instituted along with diuretics and captopril. The patient was followed for a period of 14 months. Clinical and biochemical euthyroidism was attained after 4 months of treatment. Resolution of right ventricular failure and normalization of pulmonary artery pressure occurred 11 and 14 months after initiation of therapy, respectively. Investigating thyroid status in patients with pulmonary hypertension is recommended. In patients with hyperthyroidism and (otherwise unexplained) pulmonary hypertension, restoration of euthyroidism may cure right ventricular failure and restore normal pulmonary artery pressure.
成人甲状腺功能亢进症伴发肺动脉高压的报道日益增多。尽管其机制尚不确定，但甲状腺功能恢复正常后肺动脉高压的逆转支持了两者之间的因果关系。本病例报告的是一名43岁女性，患有格雷夫斯病并出现右心室衰竭。超声心动图显示严重肺动脉高压、中度至重度三尖瓣反流、左心功能正常且气泡造影检查为阴性。开始使用卡比马唑治疗并联合利尿剂和卡托普利。对该患者进行了14个月的随访。治疗4个月后实现了临床和生化甲状腺功能正常。治疗开始后11个月和14个月，右心室衰竭得到缓解，肺动脉压力恢复正常。建议对肺动脉高压患者进行甲状腺状态检查。对于甲状腺功能亢进症合并（无其他明确原因的）肺动脉高压患者，恢复甲状腺功能正常可能治愈右心室衰竭并使肺动脉压力恢复正常。
