title: Rapid progression to pulmonary arterial hypertension crisis associated with mixed connective tissue disease in an 11-year-old girl.
abstract: Mixed connective tissue disease (MCTD) is rare in pediatric rheumatic diseases. Pulmonary arterial hypertension (PAH) associated with MCTD usually progresses gradually and is difficult to note at the asymptomatic phase. We report a 11-year-old girl with MCTD complicated with rapidly progressive PAH. Although PAH was not detected by echocardiogram or chest CT scan at the initial examination, it became clear in 1 year and suddenly came to cardiac arrest during an invasive procedure. She was successfully treated with extracorporeal assist and both vasodilative and immunosuppressive medication. A combination of echocardiogram and plasma BNP levels could be a useful marker for the follow-up of such cases. PAH could develop early in the course of pediatric MCTD and needs attention to unexpected acute exacerbation, especially under emotional stress.
authors.affiliation: Department of Pediatrics, Hokkaido University Graduate School of Medicine, North 15 West 7, Kita-ku, Sapporo 060-8638, Japan. okura@med.hokudai.ac.jp
authors.forename: Yuka
authors.initials: Y
authors.lastname: Okura
authors.forename: Shunichiro
authors.initials: S
authors.lastname: Takezaki
authors.forename: Yasuhiro
authors.initials: Y
authors.lastname: Yamazaki
authors.forename: Masafumi
authors.initials: M
authors.lastname: Yamada
authors.forename: Ichiro
authors.initials: I
authors.lastname: Kobayashi
authors.forename: Tadashi
authors.initials: T
authors.lastname: Ariga
mesh_terms: D000208:Acute Disease; D002648:Child; D018450:Disease Progression; D065627:Familial Primary Pulmonary Hypertension; D005260:Female; D006801:Humans; D006976:Hypertension, Pulmonary / Q000175:diagnosis* / Q000209:etiology; D008947:Mixed Connective Tissue Disease / Q000150:complications* / Q000175:diagnosis