[Pulmonary hypertension in sickle cell anemia. A case report].
We report the case of a 33-years-girl with SCA and severe PH. She developed six month before admission, non productive cough and dyspnea. Physical examination at admission revealed shortness of breath and right heart ventricular failure. Electrocardiography showed sinus rhythm and an incomplete left bundle branch block. Chest roentgenography revealed cardiomegaly with cardiothoracic index at 0.66 and pulmonary infiltrates. Laboratory tests revealed an anemia with hemoglobin of 7.1 g/dl, white blood cell count of 12,500/mm, moderate renal failure (cretininemia = 178 mumol/l) and hypoxemia with oxygen pressure of 60 mmHg. Hemoglobin electrophoresis revealed on heterozygous SCA. Echocardiography revealed dilatation of right heart cavities and a systolic pulmonary artery pressure of 60 mmHg. A perfusion lung scintigraphy demonstrated multiple subsegmental perfusion defects. PH is a common complication of adult patients with SCA. Appropriate therapies and strategies for prevention of PH in SCA are unknown. Further research exploring therapies such as oxygen, nitric oxide, prostacyclin and hydroxyurea are indicated.
Boussaada
Rafik
R
Service des Explorations Fonctionnelles Cardiologiques, Hôpital la Rabta, Tunis.
Boubaker
Karima
K
Mourali
Sami
S
Mbarek
Mohamed
M
Ouertani
Mohamed Walid
MW
Mechmèche
Rachid
R
D000328:Adult; D000755:Anemia, Sickle Cell / Q000150:complications*; D006332:Cardiomegaly / Q000000981:diagnostic imaging / Q000209:etiology*; D004452:Echocardiography; D004562:Electrocardiography; D005260:Female; D006801:Humans; D006976:Hypertension, Pulmonary / Q000209:etiology* / Q000473:pathology / Q000628:therapy; D011859:Radiography