title: [Severe pulmonary hypertension and congestive heart failure in an elderly patient with Basedow's disease].
abstract: An 83-year-old woman was admitted to our hospital with dyspnea. A chest X-ray showed cardiomegaly and pulmonary congestion. An echocardiogram revealed severe tricuspid regurgitation and markedly elevated transtricuspid pressure gradient of 103 mmHg. There was no left ventricular systolic or diastolic dysfunction. Laboratory evaluation revealed elevated free T4 and suppressed TSH levels. Serum level of anti-TSH receptor antibody was significantly elevated. A thyroid echogram demonstrated increased internal flow pattern in the thyroid gland. As a result of these findings, she was given a diagnosis of Basedow's disease associated with severe pulmonary hypertension and congestive heart failure. After treatment for hyperthyroidism with thiamazole, propranolol, furosemide, and warfarin, she made good recovery with gradual resolution of pulmonary hypertension. The severity of pulmonary hypertension in this case was significantly higher than that in previous reports, possibly because of concomitant minor pulmonary embolism, thiamine deficiency and anemia. In summary, we report a rare case of Basedow's disease with severe and reversible pulmonary hypertension that appeared in very old age.
authors.affiliation: Department of Medicine and Geriatrics, Kochi Medical School, Japan.
authors.forename: Kosuke
authors.initials: K
authors.lastname: Hamagawa
authors.forename: Toshikazu
authors.initials: T
authors.lastname: Yabe
authors.forename: Kayo
authors.initials: K
authors.lastname: Hayato
authors.forename: Naohito
authors.initials: N
authors.lastname: Yamasaki
authors.forename: Hiroaki
authors.initials: H
authors.lastname: Kitaoka
authors.forename: Yoshihisa
authors.initials: Y
authors.lastname: Matsumura
authors.forename: Jun
authors.initials: J
authors.lastname: Takata
authors.forename: Masanori
authors.initials: M
authors.lastname: Nishinaga
authors.forename: Yoshinori
authors.initials: Y
authors.lastname: Doi
mesh_terms: D000369:Aged, 80 and over; D005260:Female; D006111:Graves Disease / Q000150:complications*; D006801:Humans; D006976:Hypertension, Pulmonary / Q000150:complications*