Pulmonary hypertension in men with thyrotoxicosis.
Thyrotoxicosis has a myriad of respiratory symptoms including dyspnea. Pulmonary hypertension may contribute to the respiratory symptoms of thyrotoxicosis, but is often unrecognized. We describe 3 male patients with thyrotoxicosis and associated pulmonary hypertension. Case reports of an additional 15 patients are also reviewed. In patients with thyrotoxicosis and pulmonary hypertension, treatment of thyrotoxicosis alone is associated with improvement in pulmonary hypertension. Previous reports have consisted of mostly female patients, but we report 3 men. When all cases are considered, the typical patient is female (10/14 = 71%), middle-aged (48 years), with mean pulmonary artery systolic pressures improving from 56 to 32 mm Hg with treatment. Autoantibodies were detected in 10/14 (71%) patients. The response to treatment (medical or surgical) of thyrotoxicosis supports the hypothesis that hyperthyroidism is either a cause of pulmonary hypertension, or a factor that may unmask pulmonary hypertension. Recognition is important since treatment and response are very different compared to other patients with pulmonary hypertension. This association may not be readily considered in men, since most reports have been of women.
Soroush-Yari
Ardeshir
A
Pulmonary and Critical Care Section, Department of Medicine, VA Greater Los Angeles Healthcare System, UCLA School of Medicine, Los Angeles, Calif., USA.
Burstein
Samuel
S
Hoo
Guy W Soo
GW
Santiago
Silverio M
SM
D000328:Adult; D000368:Aged; D000959:Antihypertensive Agents / Q000627:therapeutic use; D013956:Antithyroid Agents / Q000627:therapeutic use; D018450:Disease Progression; D004359:Drug Therapy, Combination; D004452:Echocardiography; D006801:Humans; D006976:Hypertension, Pulmonary / Q000175:diagnosis / Q000188:drug therapy / Q000209:etiology* / Q000503:physiopathology; D007457:Iodine Radioisotopes / Q000627:therapeutic use; D008297:Male; D008875:Middle Aged; D011433:Propranolol / Q000627:therapeutic use; D011441:Propylthiouracil / Q000627:therapeutic use; D011669:Pulmonary Wedge Pressure / Q000502:physiology; D013971:Thyrotoxicosis / Q000097:blood / Q000150:complications* / Q000188:drug therapy; D013972:Thyrotropin / Q000097:blood; D013974:Thyroxine / Q000097:blood
D000959:Antihypertensive Agents; D013956:Antithyroid Agents; D007457:Iodine Radioisotopes; D011441:Propylthiouracil; D013972:Thyrotropin; D011433:Propranolol; D013974:Thyroxine