| Abstrakt: |
The article cites a case study of severe pulmonary hypertension without significant pulmonary parenchymal disease in a pediatric patient with AIDS. Features of this case differ from those of adult AIDS patients and suggest that the natural history and optimal management of pediatric AIDS-related pulmonary hypertension may differ from that of the adult variety. The patient, a child of an intravenous drug abuser, presented at 2 years of age with failure to thrive, adenopathy, hepatosplenomegaly, and chronic impetigo. Serologic testing revealed the presence of HIV infection. At 6 years of age, he developed pneumonia and was successfully treated with antibiotics. Five months later he contracted pneumonia once again. Cardiac examination at that time was remarkable for a 3/6 holosystolic and a 2/6 decrescendo diastolic murmur at the left sternal border, a loud, single second heart sound, and a parasternal heave. Echocardiography revealed marked dilation of the right atrium, right ventricle, and pulmonary artery, in association with tricuspid and pulmonary insufficiency. |
