Autoimmune thyroid disease is common in
patients with pulmonary hypertension
(March 2003)
The background of
the study. Primary pulmonary hypertension is a rare disorder
that is characterized by a progressive increase in pulmonary artery
blood pressure in the absence of heart or lung disease. It may be
an autoimmune disease. In this study, the frequency of thyroid dysfunction
and autoimmunity was determined in patients with primary pulmonary
hypertension.
How the study was done. Sixty-three
patients with primary pulmonary hypertension were studied. The diagnosis
was based on a high resting pulmonary artery blood pressure (>25
mm Hg) and the absence of heart or lung disease. The patients were
evaluated for thyroid disease by history, physical examination,
and measurements of serum thyrotropin, free thyroxine, and antithyroid
peroxidase and antithyroglobulin antibodies. The patients were categorized
as having Graves' disease (hyperthyroidism and diffuse goiter),
Hashimoto's disease (two of the following-diffuse goiter, a high
serum antithyroid antibody concentration, and repeatedly high serum
TSH concentrations), and autoimmune thyroid disease (any one of
the three findings).
The results of the study. The mean
age of the 63 patients (53 women; 10 men) was 47 years. The cause
of pulmonary hypertension was not known in 24 patients; it was associated
with a connective-tissue disorder in 13 patients, liver disease
in 6 patients, anorexigenic drugs or drug abuse (cocaine, amphetamine)
in 17 patients, and HIV infection in 3 patients. Thirty-one patients
(49 percent) had a thyroid disorder. Among these 31 patients, 45
percent had Hashimoto's disease, 26 percent had Graves' disease,
and 26 percent had autoimmune thyroid disease (3 percent had autoimmune
pituitary disease).
The conclusions of the study. Approximately
half of patients with pulmonary hypertension have thyroid autoimmune
disease.
The original article. Chu JW, Kao
PN, Faul JL, Doyle RL. High prevalence of autoimmune thyroid disease
in pulmonary arterial hypertension. Chest 2002;122:1668-73
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