Low-dose epoprostenol improved pulmonary hypertension in a patient with systemic lupus erythematosus.
A 43-year-old Japanese woman was referred to our hospital in 1997 because of Raynaud's phenomenon. Systemic lupus erythematosus was diagnosed on the basis of the presence of antinuclear antibody (1:1,280), anti-DNA antibody (1:640), anti-Sm antibody, antiphospholipid antibody, lymphopenia, and proteinuria. She developed pulmonary fibrosis in 1999 and pulmonary hypertension in 2001. In October 2002, a 24-hr continuous infusion of epoprostenol was started. Dyspnea, Raynaud's phenomenon, and pulmonary hypertension improved with low-dose epoprostenol (3.0 to 4.0 ng kg(-1) min(-1)). The patient could not tolerate larger doses of epoprostenol so 4.0 ng kg(-1) min(-1) was selected as the maintenance dose. The clinical course was uneventful at this dosage. It appears that pulmonary hypertension can be controlled with low-dose epoprostenol such as 3.0 to 4.0 ng kg(-1) min(-1) in some rheumatic patients.
Matsukawa
Yoshihiro
Y
Division of Hematology and Rheumatology, Department of Medicine, Nihon University School of Medicine, Oyaguchi-Kamimachi, Itabashi, Tokyo 173-8610, Japan. m-2000@mbk.ocn.ne.jp
Igei
Kohmei
K
Nozaki
Takamasa
T
Ohki
Takafumi
T
Shimizu
Takako
T
Kitamura
Noboru
N
Mitamura
Ko
K
Takei
Masami
M
Kasamaki
Yuji
Y
Sawada
Shigemasa
S
D000328:Adult; D000959:Antihypertensive Agents / Q000008:administration & dosage*; D011464:Epoprostenol / Q000008:administration & dosage*; D005260:Female; D006801:Humans; D006976:Hypertension, Pulmonary / Q000188:drug therapy* / Q000209:etiology*; D008180:Lupus Erythematosus, Systemic / Q000150:complications*
D000959:Antihypertensive Agents; D011464:Epoprostenol