Whipple’s Disease-Associated Pulmonary Hypertension with Positive Vasodilator Response Despite Severe Hemodynamic Derangements
Pulmonary hypertension (PH) associated with Whipple’s disease (WD-PH) is extremely rare, and the underlying pathophysiological processes are incompletely understood. Alterations in hemodynamics can be severe, with right ventricular (RV) dysfunction being common. A case involving a 23-year-old man wi...
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| Format: | Article |
| Language: | English |
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Wiley
2011-01-01
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| Series: | Canadian Respiratory Journal |
| Online Access: | http://dx.doi.org/10.1155/2011/365645 |
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| author | Salah Najm Joud Hajjar Robert P Nelson Ramana S Moorthy Karen M Wolf Tim Lahm |
| author_facet | Salah Najm Joud Hajjar Robert P Nelson Ramana S Moorthy Karen M Wolf Tim Lahm |
| author_sort | Salah Najm |
| collection | DOAJ |
| description | Pulmonary hypertension (PH) associated with Whipple’s disease (WD-PH) is extremely rare, and the underlying pathophysiological processes are incompletely understood. Alterations in hemodynamics can be severe, with right ventricular (RV) dysfunction being common. A case involving a 23-year-old man with WD-PH who exhibited a dramatic vasodilator response during right heart catheterization despite severely altered pulmonary hemodynamics and concomitant RV dysfunction is reported. While the patient’s symptoms responded poorly to treatment with nifedipine and sildenafil, significant improvement in dyspnea, RV dysfunction and pulmonary pressures were noted following antibiotic therapy. The present report highlights that despite severely elevated pulmonary artery pressures and RV dysfunction in WD-PH patients, a highly significant vasodilator response and dramatic improvement with antibiotic therapy may be observed. Furthermore, the case highlights the phenomenon of PH in the setting of inflammation, suggesting that adequate control of the inflammatory response can be accompanied by a marked improvement in hemodynamics in certain types of PH. |
| format | Article |
| id | doaj-art-df38ba1fd0634a3e8f47539e6e5e5060 |
| institution | Kabale University |
| issn | 1198-2241 |
| language | English |
| publishDate | 2011-01-01 |
| publisher | Wiley |
| record_format | Article |
| series | Canadian Respiratory Journal |
| spelling | doaj-art-df38ba1fd0634a3e8f47539e6e5e50602025-02-03T05:51:48ZengWileyCanadian Respiratory Journal1198-22412011-01-01185e70e7210.1155/2011/365645Whipple’s Disease-Associated Pulmonary Hypertension with Positive Vasodilator Response Despite Severe Hemodynamic DerangementsSalah Najm0Joud Hajjar1Robert P Nelson2Ramana S Moorthy3Karen M Wolf4Tim Lahm5Department of Medicine, St Vincent Hospital Indianapolis, USADepartment of Medicine, St Vincent Hospital Indianapolis, USADepartment of Medicine, St Vincent Hospital Indianapolis, USAAssociated Vitreoretinal and Uveitis Consultants Indianapolis, St Vincent Hospital Indianapolis, and Department of Ophthalmology, USADepartment of Medicine, St Vincent Hospital Indianapolis, USADepartment of Medicine, St Vincent Hospital Indianapolis, USAPulmonary hypertension (PH) associated with Whipple’s disease (WD-PH) is extremely rare, and the underlying pathophysiological processes are incompletely understood. Alterations in hemodynamics can be severe, with right ventricular (RV) dysfunction being common. A case involving a 23-year-old man with WD-PH who exhibited a dramatic vasodilator response during right heart catheterization despite severely altered pulmonary hemodynamics and concomitant RV dysfunction is reported. While the patient’s symptoms responded poorly to treatment with nifedipine and sildenafil, significant improvement in dyspnea, RV dysfunction and pulmonary pressures were noted following antibiotic therapy. The present report highlights that despite severely elevated pulmonary artery pressures and RV dysfunction in WD-PH patients, a highly significant vasodilator response and dramatic improvement with antibiotic therapy may be observed. Furthermore, the case highlights the phenomenon of PH in the setting of inflammation, suggesting that adequate control of the inflammatory response can be accompanied by a marked improvement in hemodynamics in certain types of PH.http://dx.doi.org/10.1155/2011/365645 |
| spellingShingle | Salah Najm Joud Hajjar Robert P Nelson Ramana S Moorthy Karen M Wolf Tim Lahm Whipple’s Disease-Associated Pulmonary Hypertension with Positive Vasodilator Response Despite Severe Hemodynamic Derangements Canadian Respiratory Journal |
| title | Whipple’s Disease-Associated Pulmonary Hypertension with Positive Vasodilator Response Despite Severe Hemodynamic Derangements |
| title_full | Whipple’s Disease-Associated Pulmonary Hypertension with Positive Vasodilator Response Despite Severe Hemodynamic Derangements |
| title_fullStr | Whipple’s Disease-Associated Pulmonary Hypertension with Positive Vasodilator Response Despite Severe Hemodynamic Derangements |
| title_full_unstemmed | Whipple’s Disease-Associated Pulmonary Hypertension with Positive Vasodilator Response Despite Severe Hemodynamic Derangements |
| title_short | Whipple’s Disease-Associated Pulmonary Hypertension with Positive Vasodilator Response Despite Severe Hemodynamic Derangements |
| title_sort | whipple s disease associated pulmonary hypertension with positive vasodilator response despite severe hemodynamic derangements |
| url | http://dx.doi.org/10.1155/2011/365645 |
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