Whipple’s Disease-Associated Pulmonary Hypertension with Positive Vasodilator Response Despite Severe Hemodynamic Derangements
| Autor: | Tim Lahm, Robert P. Nelson, Joud Hajjar, Salah Najm, Ramana S. Moorthy, Karen M. Wolf |
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| Rok vydání: | 2011 |
| Předmět: |
Male
Pulmonary and Respiratory Medicine Sildenafil Hypertension Pulmonary Ventricular Dysfunction Right Hemodynamics Case Report Vasodilation Nitric Oxide Young Adult Diseases of the respiratory system chemistry.chemical_compound Nifedipine medicine.artery medicine Humans Whipple's disease RC705-779 business.industry medicine.disease Pulmonary hypertension Pathophysiology Bronchodilator Agents chemistry Anesthesia Pulmonary artery business Whipple Disease medicine.drug |
| Zdroj: | Canadian Respiratory Journal, Vol 18, Iss 5, Pp e70-e72 (2011) |
| ISSN: | 1198-2241 |
| Popis: | Pulmonary hypertension (PH) associated with Whipple’s disease (WD-PH) is extremely rare, and the underlying pathophysiological processes are incompletely understood. Alterations in hemodynamics can be severe, with right ventricular (RV) dysfunction being common. A case involving a 23-year-old man with WD-PH who exhibited a dramatic vasodilator response during right heart catheterization despite severely altered pulmonary hemodynamics and concomitant RV dysfunction is reported. While the patient’s symptoms responded poorly to treatment with nifedipine and sildenafil, significant improvement in dyspnea, RV dysfunction and pulmonary pressures were noted following antibiotic therapy. The present report highlights that despite severely elevated pulmonary artery pressures and RV dysfunction in WD-PH patients, a highly significant vasodilator response and dramatic improvement with antibiotic therapy may be observed. Furthermore, the case highlights the phenomenon of PH in the setting of inflammation, suggesting that adequate control of the inflammatory response can be accompanied by a marked improvement in hemodynamics in certain types of PH. |
| Databáze: | OpenAIRE |
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