Department of Chest Medicine, Institute of Tuberculosis and Lung Diseases, Warsaw.
Department of Chest Medicine, Institute of Tuberculosis and Lung Diseases, Warsaw.
Chest. 2011 Mar;139(3):690-693. doi: 10.1378/chest.10-1134.
Hemoptysis is a rarely reported complication of idiopathic pulmonary arterial hypertension (IPAH). We present the case of a 27-year-old woman with IPAH, who suffered from recurrent hemoptysis and who was treated with sitaxsentan and treprostinil and remained stable in World Health Organization functional class II. During several episodes of active hemoptysis, the patient underwent bronchial artery embolization (BAE), always with good immediate results. She developed severe respiratory insufficiency and died of electromechanical dissociation 2 days after another episode, despite effective bleeding control. Recurrent hemoptysis in patients with IPAH emerges as a potential indication for urgent placement on the lung transplant list, independent from the classic prognostic factors of functional class and indices of right-sided ventricular function. Repeated BAE should not be considered as a definitive treatment in patients with pulmonary arterial hypertension with recurrent bleeding, although it may help in bridging patients to lung transplant.
咯血是特发性肺动脉高压（IPAH）少见的并发症。我们报告了 1 例 27 岁 IPAH 女性患者，该患者反复咯血，接受西他生坦和曲前列尼尔治疗，WHO 功能分级 II 级稳定。在几次咯血发作期间，患者接受了支气管动脉栓塞（BAE）治疗，结果总是立竿见影。尽管出血得到有效控制，但在另一次咯血发作后 2 天，患者出现严重呼吸功能不全，死于电机械分离。反复咯血是 IPAH 患者的一个潜在的紧急肺移植适应证，独立于功能分级和右心室功能指数等经典预后因素。对于反复出血的肺动脉高压患者，反复 BAE 不应被视为一种确定性治疗方法，尽管它可以帮助患者过渡到肺移植。
