0
Communications to the Editor |

Pulmonary Arterial Hypertension and Thyroid Disease FREE TO VIEW

Anne Ferris, MD; Thomas Jacobs, MD; Allison Widlitz, MS, PA; Robyn J. Barst, MD; Jane H. Morse, MD
Author and Funding Information

Columbia University New York, NY

Correspondence to: Robyn J. Barst, MD, Columbia University, College of Physicians and Surgeons, 3959 Broadway BH-262N, New York, NY 10032



Chest. 2001;119(6):1980-1981. doi:10.1378/chest.119.6.1980
Text Size: A A A
Published online

To the Editor:

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 hypertension (PAH).3

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.

Figure Jump LinkFigure 1. Figure 1. Results of thyroid function studies. M = male; F = female; CREST = calcinosis, Reynaud’s syndrome, esophageal motility disorders, sclerodactyly, and telangiectasia; Labs = laboratory findings; SLE = systemic lupus erythematosus; TSH = thyroid stimulating hormone; T4=thyroxine.Grahic Jump Location
Curnock, AL, Dweik, RA, Higgins, BH, et al (1999) High prevalence of hypothyroidism in patients with primary pulmonary hypertensionAm J Med Sci318,289-292. [CrossRef] [PubMed]
 
Nakchbandi, IA, Wirth, JA, Inzucchi, SE Pulmonary hypertension caused by Grave’s thyrotoxicosis: normal pulmonary hemodynamics restored by131I treatmentChest1999;116,1483-1485. [CrossRef] [PubMed]
 
Ferris, AM, Morse, JH, Barst, RJ, et al Thyroid disease and pulmonary arterial hypertension (PAH) in patients treated with prostacyclin [abstract]. Circulation. 2000;;102:18(suppl II) ,.:426
 
Okura, H, Takatsu, Y High-output heart failure as a cause of pulmonary hypertension.Intern Med1994;33,363-365. [CrossRef] [PubMed]
 
Thurnheer, R, Jenni, R, Russi, EW, et al Hyperthyroidism and pulmonary hypertension.J Intern Med1997;242,185-188. [CrossRef] [PubMed]
 

Figures

Figure Jump LinkFigure 1. Figure 1. Results of thyroid function studies. M = male; F = female; CREST = calcinosis, Reynaud’s syndrome, esophageal motility disorders, sclerodactyly, and telangiectasia; Labs = laboratory findings; SLE = systemic lupus erythematosus; TSH = thyroid stimulating hormone; T4=thyroxine.Grahic Jump Location

Tables

References

Curnock, AL, Dweik, RA, Higgins, BH, et al (1999) High prevalence of hypothyroidism in patients with primary pulmonary hypertensionAm J Med Sci318,289-292. [CrossRef] [PubMed]
 
Nakchbandi, IA, Wirth, JA, Inzucchi, SE Pulmonary hypertension caused by Grave’s thyrotoxicosis: normal pulmonary hemodynamics restored by131I treatmentChest1999;116,1483-1485. [CrossRef] [PubMed]
 
Ferris, AM, Morse, JH, Barst, RJ, et al Thyroid disease and pulmonary arterial hypertension (PAH) in patients treated with prostacyclin [abstract]. Circulation. 2000;;102:18(suppl II) ,.:426
 
Okura, H, Takatsu, Y High-output heart failure as a cause of pulmonary hypertension.Intern Med1994;33,363-365. [CrossRef] [PubMed]
 
Thurnheer, R, Jenni, R, Russi, EW, et al Hyperthyroidism and pulmonary hypertension.J Intern Med1997;242,185-188. [CrossRef] [PubMed]
 
NOTE:
Citing articles are presented as examples only. In non-demo SCM6 implementation, integration with CrossRef’s "Cited By" API will populate this tab (http://www.crossref.org/citedby.html).

Some tools below are only available to our subscribers or users with an online account.

Related Content

Customize your page view by dragging & repositioning the boxes below.

  • CHEST Journal
    Print ISSN: 0012-3692
    Online ISSN: 1931-3543