LETTER
Hypothyroidism and Primary Pulmonary Hypertension
Jeffrey Fisher, MD
15 January 1994 | Volume 120 Issue 2 | Pages 167-168
TO THE EDITOR:
In preparing their recent report of four patients with primary pulmonary hypertension and hypothyroidism, Badesch and colleagues [1] found no previous observation of this association.
In 1986, we described three patients with primary pulmonary hypertension associated with hypothyroidism and six patients with hypothyroidism, pulmonary hypertension, and connective tissue disorders [2].
In addition to an autoimmune pathogenesis, we noted the long-observed association between systemic hypertension and hypothyroidism and discussed potential humoral, thrombotic, and rheologic mechanisms that might provide a pathophysiologic link between hypothyroidism and pulmonary hypertension.
However enticing the putative mechanisms may be, the association is not common and may not be causally related. In our reports, we also discuss the controversies involved in thyroid replacement in these patients.
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Author and Article Information
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The New York Hospital-Cornell Medical Center; New York, NY 10021
1. Badesch DB, Wynne KM, Bonvallet S, Voelkel NF, Ridgway C, Groves BM. Hypothyroidism and primary pulmonary hypertension: an autoimmune pathogenetic link? Ann Intern Med. 1993; 119:44-6.
2. Chin RG, Fisher J. Hypothyroidism and pulmonary hypertension: observation and speculation. Cardiovascular Reviews and Reports. 1986; 7:789-95.
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