New York, NY
Correspondence to: Robyn J. Barst, MD, Columbia University, College of Physicians and Surgeons, 3959 Broadway BH-262N, New York, NY 10032
We have been following with interest the articles by
Curnock et al1and Nakchbandi et al2–
commenting on the association of thyroid disease and
primary pulmonary hypertension (PPH). We would like to draw attention
to our recent observations of thyroid disease and pulmonary artery
Although an increased prevalence of thyroid disease has been
reported in patients with PAH, whether long-term treatment with
prostacyclin (PGI2) plays a role is unclear. We performed a
retrospective analysis of thyroid function studies in 134 adults (112
with PPH and 22 with connective tissue disease [CTD]) with PPH or PAH
associated with CTD, and in 78 children with PPH (Fig. 1).
The objective of our study was to determine if long-term therapy with
PGI2 “induces” or “unmasks” thyroid disease in
patients with PAH. Twenty of the 26 adult patients (16 with PPH and 10
with CTD) with thyroid disease were treated with long-term
PGI2 therapy, and 11 patients (all with PPH) of these 20
developed thyroid disease after starting PGI2 therapy. Five
of these 11 patients had thyrotoxicosis at the time of evaluation. The
remaining nine patients with thyroid disease prior to starting
long-term PGI2 therapy were all hypothyroid, as were the
six patients who were never treated with PGI2. Eight of the
78 PPH children had thyroid disease, and 6 of the 8 children developed
the disease after starting PGI2.
Although our data on prevalence of patients with hypothyroidism
and PPH (9% in adults and 6.5% in children) are similar to finding of
previously published reports, prior reports of hyperthyroidism with PPH
have only included single case reports4and one case
series of four patients with PAH in whom the PAH resolved in all four
patients when their hyperthyroidism was treated.5 The
increased occurrence in our study of hyperthyroid disease in PPH
patients receiving long-term PGI2 therapy raises the
possibility that PGI2 treatment may be a trigger to the
development of thyroid disease; further investigation is warranted.
Become a CHEST member and receive a FREE subscription as a benefit of membership.
Individuals can purchase this article on ScienceDirect.
Individuals can purchase a subscription to the journal.
Individuals can purchase a subscription to the journal or buy individual articles.
Learn more about membership or Purchase a Full Subscription.
Institutional access is now available through ScienceDirect and can be purchased at myelsevier.com.
Some tools below are only available to our subscribers or users with an online account.
Download citation file:
Web of Science® Times Cited: 20
Customize your page view by dragging & repositioning the boxes below.
Enter your username and email address. We'll send you a reminder to the email address on record.
Athens and Shibboleth are access management services that provide single sign-on to protected resources. They replace the multiple user names and passwords necessary to access subscription-based content with a single user name and password that can be entered once per session. It operates independently of a user's location or IP address. If your institution uses Athens or Shibboleth authentication, please contact your site administrator to receive your user name and password.