title: Nitric oxide-sensitive pulmonary hypertension in congenital rubella syndrome.
abstract: Persistent pulmonary hypertension is a very rare presentation of congenital virus infection. We discuss the case of complete congenital rubella syndrome presenting at echocardiography with pulmonary hypertension that worsened after ductus ligation. Cardiac catheterization showed a normal pulmonary valve and vascular tree but a PAP = 40 mmHg. The infant promptly responded to inhaled nitric oxide while on mechanical ventilation and was later shifted to oral sildenafil. It is not clear whether our observation may be due to direct viral damage to the endothelium or to the rubella virus increasing the vascular tone via a metabolic derangement.
authors.affiliation: Division of Neonatology, Section of Pediatrics, Department of Translational Medical Sciences, Università "Federico II", Via Pansini 5, 80131 Naples, Italy.
authors.forename: Francesco
authors.initials: F
authors.lastname: Raimondi
authors.affiliation: Division of Neonatology, Section of Pediatrics, Department of Translational Medical Sciences, Università "Federico II", Via Pansini 5, 80131 Naples, Italy.
authors.forename: Fiorella
authors.initials: F
authors.lastname: Migliaro
authors.affiliation: Division of Cardiology, Department of Advanced Biomedical Sciences, Università "Federico II", Via Pansini 5, 80131 Naples, Italy.
authors.forename: Elisa
authors.initials: E
authors.lastname: Di Pietro
authors.affiliation: Division of Cardiology, Department of Advanced Biomedical Sciences, Università "Federico II", Via Pansini 5, 80131 Naples, Italy.
authors.forename: Francesco
authors.initials: F
authors.lastname: Borgia
authors.affiliation: Division of Cardiology, Department of Advanced Biomedical Sciences, Università "Federico II", Via Pansini 5, 80131 Naples, Italy.
authors.forename: Antonio
authors.initials: A
authors.lastname: Rapacciuolo
authors.affiliation: Division of Neonatology, Section of Pediatrics, Department of Translational Medical Sciences, Università "Federico II", Via Pansini 5, 80131 Naples, Italy.
authors.forename: Letizia
authors.initials: L
authors.lastname: Capasso