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Sarcoidosis and reactive pulmonary hypertension
Archives of Internal Medicine
|November 1, 1985
Summary
Pulmonary hypertension in sarcoidosis is rare. This study found it may stem from abnormal pulmonary vascular tone, not just vessel obliteration, involving thromboxane.
Area of Science:
- Pulmonary Medicine
- Cardiology
- Immunology
Background:
- Sarcoidosis is a multisystem inflammatory disease.
- Pulmonary hypertension (PH) is an uncommon complication of sarcoidosis, affecting 1-4% of patients.
- PH in sarcoidosis is typically associated with obliterative pulmonary vascular disease.
Observation:
- A case of sarcoidosis with severe PH was observed.
- This case presented without the usual obliterative pulmonary vascular disease.
- This suggested an alternative mechanism for PH in sarcoidosis.
Findings:
- Pharmacologic studies were conducted to investigate pulmonary vascular tone.
- Pulmonary vasodilatation was demonstrated, indicating a responsive vascular bed.
- Increased pulmonary blood flow led to the release of thromboxane, a vasoconstricting eicosanoid.
Implications:
- Abnormal pulmonary vascular tone, rather than solely vascular obstruction, may cause PH in sarcoidosis.
- Thromboxane elaboration could play a role in sarcoidosis-associated PH.
- Further research into vascular tone modulation may offer new therapeutic targets for PH in sarcoidosis.