Pulmonary Hypertension in Men with Thyrotoxicosis

• Published in: Respiration Vol. 72; no. 1; pp. 90 - 94
• Main Authors: Soroush-Yari, Ardeshir, Burstein, Samuel, Hoo, Guy W. Soo, Santiago, Silverio M.
• Format: Journal Article
• Language: English
• Published: Basel, Switzerland Karger 01.01.2005; S. Karger AG
• Subjects: Adult; Aged; Antihypertensive Agents - therapeutic use; Antithyroid Agents - therapeutic use; Biological and medical sciences; Case Report; Disease Progression; Drug Therapy, Combination; Echocardiography; Endocrinopathies; Humans; Hypertension; Hypertension, Pulmonary - diagnosis; Hypertension, Pulmonary - drug therapy; Hypertension, Pulmonary - etiology; Hypertension, Pulmonary - physiopathology; Iodine Radioisotopes - therapeutic use; Male; Medical sciences; Men; Middle Aged; Non tumoral diseases. Target tissue resistance. Benign neoplasms; Pneumology; Propranolol - therapeutic use; Propylthiouracil - therapeutic use; Pulmonary hypertension. Acute cor pulmonale. Pulmonary embolism. Pulmonary vascular diseases; Pulmonary Wedge Pressure - physiology; Respiratory diseases; Respiratory system; Thyroid. Thyroid axis (diseases); Thyrotoxicosis - blood; Thyrotoxicosis - complications; Thyrotoxicosis - drug therapy; Thyrotropin - blood; Thyroxine - blood; Hyperthyroidism; Pulmonary hypertension; Dyspnea; Endocrinopathy; Human; Respiratory disease; Thyroid diseases; Cardiovascular disease; Dyspnea Hyperthyroidism
• ISSN: 0025-7931; 1423-0356
• DOI: 10.1159/000083408

Thyrotoxicosis has a myriad of respiratory symptoms including dyspnea. Pulmonary hypertension may contribute to the respiratory symptoms of thyrotoxicosis, but is often unrecognized. We describe 3 male patients with thyrotoxicosis and associated pulmonary hypertension. Case reports of an additional 15 patients are also reviewed. In patients with thyrotoxicosis and pulmonary hypertension, treatment of thyrotoxicosis alone is associated with improvement in pulmonary hypertension. Previous reports have consisted of mostly female patients, but we report 3 men. When all cases are considered, the typical patient is female (10/14 = 71%), middle-aged (48 years), with mean pulmonary artery systolic pressures improving from 56 to 32 mm Hg with treatment. Autoantibodies were detected in 10/14 (71%) patients. The response to treatment (medical or surgical) of thyrotoxicosis supports the hypothesis that hyperthyroidism is either a cause of pulmonary hypertension, or a factor that may unmask pulmonary hypertension. Recognition is important since treatment and response are very different compared to other patients with pulmonary hypertension. This association may not be readily considered in men, since most reports have been of women.