Sarcoidosis-associated pulmonary hypertension: a role for endothelin receptor antagonists?
Data on the treatment of sarcoidosis-associated pulmonary hypertension are scarce, while the variety of underlying pathophysiologic mechanisms are a major limitation in the implementation of a universal therapy. We report a 47-year-old male patient who presented with stage II sarcoidosis and associated severe pulmonary hypertension. Corticosteroid treatment resolved parenchymal lesions of the lung while vascular involvement did not respond, with the patient remaining in poor functional status. Addition of bosentan, a dual endothelin receptor antagonist, resulted in marked improvement in functional class and exercise capacity of the patient, allowing gradual tapering of steroids.
Pitsiou
Georgia G
GG
Respiratory Failure Unit, 'G. Papanikolaou' Hospital, Aristotle University of Thessaloniki, Thessaloniki, Greece. gpitsiou@yahoo.gr
Spyratos
Dionysis
D
Kioumis
Ioannis
I
Boutou
Afroditi K
AK
Nakou
Chrysanthi
C
Stanopoulos
Ioannis
I
D000077300:Bosentan; D065128:Endothelin Receptor Antagonists; D006801:Humans; D006976:Hypertension, Pulmonary / Q000188:drug therapy* / Q000209:etiology; D008297:Male; D008875:Middle Aged; D017565:Sarcoidosis, Pulmonary / Q000150:complications*; D013449:Sulfonamides / Q000627:therapeutic use*
D065128:Endothelin Receptor Antagonists; D013449:Sulfonamides; D000077300:Bosentan