Hipertensão pulmonar esquistossomotica persistente em paciente após reversão da forma hépato-esplênica: apresentação de um caso

Abstract

Os autores relatam o caso de um paciente masculino, de 24 anos, hépato-esplênico e com hipertensão pulmonar esquistossomótica (pressão média na artéria pulmonar de 27,5mm HG). Tratado com oxamniquine. Após 11 anos o exame mostrou reversão à hépato-intestinal, com persistência da hipertensão pulmonar, diagnosticada pelo cateterismo cardíaco (pressão média na artéria pulmonar de 20mm Hg) e ecocardiografia.

Is pulmonary arterial hypertension associated with schistosomiasis distinct from pulmonary arterial hypertension associated with portal hypertension?

“… 52 However, patients with SchPH treated with praziquantel do not appear to have improvement in their lung disease. 53 , 54 Parasite eradication may slow the rate of progression by stopping further egg deposition in the lungs, but patients still die of SchPAH despite receiving praziquantel, avoiding reinfection by moving away from endemic settings, and not having any eggs in their lungs at the time of death. 38 These data suggest that in SchPAH, after a certain point, the liver pathology and the lung pathology become disconnected: the liver improves but the lung does not.…”