Alcázar R, Rey M, de Sequera P, Alegre R, Rovira A, Caramelo C
Servicio de Nefrología, Fundación Jiménez Díaz, Madrid.
Rev Esp Cardiol. 1995 Feb;48(2):142-4.
We report the case of a 28-year-old woman in a chronic hemodialysis program, who developed moderate pulmonary hypertension (eco-Doppler assumed pulmonary systolic pressure of 62 mmHg), with right ventricular dilatation (49 mm) in coincidence with a fully symptomatic autoimmune hyperthyroidism. The improvement of thyroid function resulted in a significant regression of pulmonary hypertension (45 mmHg) and normalization of right ventricular size (35 mm). The appearance and reversibility of pulmonary hypertension associated to autoimmune hyperthyroidism have not been described before and, in our patient, it is probably facilitated by other coincident factors that increase cardiac output and, subsequently, pulmonary flow, i.e. anemia and the arteriovenous fístula for hemodialysis.
我们报告了一名28岁处于慢性血液透析治疗阶段的女性病例,该患者出现中度肺动脉高压(经食管多普勒超声测得肺动脉收缩压为62 mmHg),伴有右心室扩张(49 mm),同时患有症状明显的自身免疫性甲状腺功能亢进症。甲状腺功能的改善导致肺动脉高压显著消退(45 mmHg),右心室大小恢复正常(35 mm)。自身免疫性甲状腺功能亢进症相关的肺动脉高压的出现及可逆性此前未见报道,在我们的患者中,可能是由其他一些同时存在的因素促成的,这些因素增加了心输出量,进而增加了肺血流量,即贫血和用于血液透析的动静脉瘘。