Autoimmune Thyroid Disease in Children and Adolescents With Idiopathic Pulmonary Arterial Hypertension

Abstract

Background: Previous studies have reported a high prevalence of autoimmune thyroid disease (AITD) in adult patients with pulmonary arterial hypertension (PAH). The aim of this retrospective study was to determine the prevalence of AITD in children and adolescents with idiopathic PAH (IPAH). Methods and Results:The study group included 16 patients who had been diagnosed as having idiopathic PAH when they were younger than 15 years old; all were younger than 20 years of age. Thyroid function and antithyroid antibody levels were examined regularly at 6-12-month intervals and when there were clinical signs of thyroid dysfunction. In total, 7 patients (44%) had AITD; 2 patients developed Graves' disease, 2 developed silent thyroiditis, and 3 had antithyroid antibodies with euthyroidism. The duration after PAH onset and the prostacyclin (PGI2) treatment period were significantly longer in patients with AITD (7.6±2.1 and 7.4±2.3 years, respectively) than in patients without AITD (5.0±1.1 and 4.8±1.2 years, respectively; P<0.01 and P<0.05). Conclusions:The prevalence of AITD is high in children and adolescents with IPAH, so evaluation of thyroid function is important to prevent deterioration of right heart failure. (Circ J 2010; 74: 371 - 374)

Identification of New Prognostic Factors of Pulmonary Hypertension

“…Indeed, 5 of 11 patients with hyperthyroidism were treated with antithyroid drugs, and 3 of 47 patients with hypothyroidism were treated with thyroid hormone replacement therapy, which is consistent with previous studies in which 22-49% of patients with PAH were complicated with thyroid dysfunction. 30, 31 The precise mechanisms of thyroid dysfunction in PH remain unclear; however, involvement of autoimmune mechanisms and the side-effects of prostacyclin therapy may be involved. 30 Indeed, it was reported that the treatment of thyroid dysfunction ameliorated PAP in PH patients complicated with thyroid diseases.…”

Interferon Therapy Exacerbated Pulmonary Hypertension in a Patient with Hepatitis C Virus Infection: Pathogenic Interplay among Multiple Risk Factors

“…However, most patients diagnosed with IFN-induced PAH in a French registry and some case reports have described the association of other risk factors with PAH, such as portal hypertension and/or human immunodeficiency virus infection (8). In this case, the patient had chronic liver disease (liver cirrhosis) and Hashimoto's thyroiditis, both of which (9-11) are known to be associated with PAH. IFN may therefore have acted as the trigger for the development of PAH and/or worsening of asymptomatic PAH in our patient.…”

Effect of treatment with epoprostenol and endothelin receptor antagonists on the development of thyrotoxicosis in patients with pulmonary arterial hypertension

“…All patients with thyrotoxicosis received epoprostenol treatment. Some studies have suggested that epoprostenol treatment is associated with the development of non-autoimmune thyrotoxicosis [5] and autoimmune thyrotoxicosis [3,4,6,7]. Prostacyclin stimulates adenylate cyclase activity and increases cyclic adenosine monophosphate (cAMP) synthesis in thyroid follicular cells via a TSHindependent system.…”