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01-12-2019 | Thyroid Disease | PULMONARY HYPERTENSION

Thyroid Dysfunction in Patients with Pulmonary Artery Hypertension (PAH): The Effect of Therapies Affecting the Prostanoid Pathway

Authors: Aravind A. Menon, Sandeep Sahay, Lewis E. Braverman, Harrison W. Farber

Published in: Lung | Issue 6/2019

Abstract

Introduction

Epoprostenol, a synthetic prostaglandin I2 (PGI₂) analog, has been the mainstay of treatment for severe pulmonary arterial hypertension (PAH) for the last two decades. Treprostinil, another synthetic prostaglandin analog, and selexipag, an oral selective Inositol Phosphate (IP) prostacyclin receptor agonist, have also been approved for treatment of PAH. Prostacyclin and its analogs cause a variety of side effects in patients with PAH; however, thyroid dysfunction is rarely reported.

Methods

After treating an index case of thyroid dysfunction occurring after initiation of epoprostenol, we reviewed our databases of PAH patients treated with epoprostenol, treprostinil or selexipag to identify the occurrence of this association.

Results

We identified six cases of thyroid dysfunction in our cohort: five after initiation of an intravenous prostacyclin (epoprostenol) and one after initiation of an oral prostacyclin receptor agonist (selexipag). Four of the patients presented with hyperthyroidism and two with a large autoimmune goiter. Graves’ disease was seen in three patients, Hashimoto’s disease in two patients and thyrotoxicosis in one patient.

Conclusion

Therapy with medications targeting the prostacyclin pathway is a potential risk factor for the development of symptomatic thyroid disease.

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Title: Thyroid Dysfunction in Patients with Pulmonary Artery Hypertension (PAH): The Effect of Therapies Affecting the Prostanoid Pathway
Authors: Aravind A. Menon
Sandeep Sahay
Lewis E. Braverman
Harrison W. Farber
Publication date: 01-12-2019
Publisher: Springer US
Keywords: Thyroid Disease
Hashimoto Thyroiditis
Thyroid Disease
Hyperthyroidism
Pulmonary Hypertension
Goiter
Pulmonary Hypertension
Hypertension
Pulmonary Hypertension
Pulmonary Hypertension
Published in: Lung / Issue 6/2019
Print ISSN: 0341-2040
Electronic ISSN: 1432-1750
DOI: https://doi.org/10.1007/s00408-019-00283-8

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Introduction

Methods

Results

Conclusion

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