A Case of Pulmonary Hypertension Recurred by Graves’ Disease

Article information

Kosin Med J. 2013;28(2):171-176

Publication date (electronic) : 2013 January 19

doi : https://doi.org/10.7180/kmj.2013.28.2.171

Jun Seop Lee , Young Sik Choi , Jae Woo Lee , Jin Seok Yoo , Youn Jung Choi , Dong Hyun Park

Department of Internal Medicine, College of Medicine, Kosin University, Busan, Korea

Corresponding author: Young Sik Choi, Department of Internal Medicine, College of Medicine, Kosin University, 34 Amnam dong, Seo-gu, Busan 602-702, Korea TEL: +82-51-990-6102 FAX: +82-51-248-5686 E-mail: yschoi@ns.kosinmed.or.kr

Received 2012 April 26; 2012 June 21; Accepted 2012 June 25.

Abstract

A few cases of severe pulmonary hypertension with right heart failure associated with Graves’ disease were reported in the literature. However, cases of pulmonary hypertension with right heart failure recurred by Graves’ disease is very rare. We describe the case of a 60-year old woman who had been treated pulmonary hypertension caused by right pulmonary artery thromboembolism seven years ago. Recently, her pulmonary hypertension with right heart failure was recurred by Graves’ disease. The patient’s symptoms of pulmonary hypertension was resolved after treatment of Graves’ disease.

Keywords: Graves’ disease; Pulmonary arterial thromboembolism; Pulmonary hypertension

Fig. 1.

(A) Huge sized thrombus in right pulmonary artery was showed in chest CT of 7 years before admission, (B) On admission day, chest CT revealed no evidence of pulmonary arterial thrombus.

Fig. 2.

On admission day, the electrocardiography showed normal sinus rhythm, right ventricular hypertrophy and ST depression in pre-cordial leads.

Fig. 3.

On admission day, transthoracic-echocardiography revealed severe pulmonary hypertension. (A) Pressure gradient between right atrium and ventricle is 85.7 mmHg, (B) Right ventricle is markedly enlarged. Left ventricle showed D-shape appearance.

Fig. 4.

Ultrasonography of the thyroid. (A) Sonogram showed diffuse enlarged thyroid gland with heterogenous echogenecity (0.92 cm of isthmus, 2.7 cm of right lobe, 2.36 cm of left lobe), (B) Sonogram presented thyroid gland with hypervascularity.

Fig. 5.

Non-visualization of both thyroid lobes (I-131 uptake = 1%).

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