Pulmonary Hypertension after Splenectomy?

Hoeper, Marius M.; Niedermeyer, J; Hoffmeyer, Frank; Flemming, Peer; Fabel, H

doi:10.7326/0003-4819-130-6-199903160-00014

Cited by 154 publications

(124 citation statements)

References 8 publications

Supporting

Mentioning

112

Contrasting

Unclassified

Order By: Relevance

“…The association of splenectomy and CTEPH, especially in nonoperable disease, has previously been described [8,9,20]. Several potential mechanisms for this phenomenon have been postulated, including loss of splenic function leading to the circulation of platelet-derived mediators, which, when acting in conjunction with abnormal erythrocytes, promote thrombus formation in the pulmonary circulation [9].…”

Section: Discussionmentioning

confidence: 99%

Prognostic and aetiological factors in chronic thromboembolic pulmonary hypertension

et al. 2008

View full text Add to dashboard Cite

Several prognostic variables have previously been identified in patients with chronic thromboembolic pulmonary hypertension (CTEPH). Specific medical conditions have also been associated with the development and prognosis of CTEPH. Using a national registry, the current authors have assessed the prognostic value of a larger number of variables and have also attempted to validate the clinical importance of previously identified aetiological factors.Baseline information for all 469 CTEPH patients diagnosed in the UK pulmonary hypertension service between January 2001 and June 2006 was collected from hospital records.Although univariate analysis confirmed the prognostic importance of pulmonary resistance, in multivariate analysis gas transfer and exercise capacity predicted pulmonary endarterectomy perioperative mortality. Cardiac index and exercise capacity independently predicted outcome in patients with nonoperable disease. Previous splenectomy was noted in 6.7% of patients, being significantly more common in patients with nonoperable than operable disease (13.7 versus 3.6%). Medical risk factors were not found to predict mortality.In a large national cohort, predictors of outcome in patients with both operable and nonoperable chronic thromboembolic pulmonary hypertension have been identified. These may be useful in planning treatment. The aetiological importance of previously identified medical risk factors has been confirmed, although the current authors were unable to validate their prognostic strength.

show abstract

Section: Discussionmentioning

confidence: 99%

Prognostic and aetiological factors in chronic thromboembolic pulmonary hypertension

et al. 2008

View full text Add to dashboard Cite

show abstract

“…More specifically, scleroderma and lupus are associated with a reduction in peripheral CD4+CD25+ cells, the putative Treg population [23][24][25]. Furthermore, PAH has been described following splenectomy [29]. Finally, it was recently reported that a patient with autoimmune polyendocrinopathy-candidiasisectodermal dystrophy, which is caused by a mutation leading to the loss of function of the autoimmune regulator (AIRE) protein, died with fatal IPAH [30].…”

Section: Pah: Autoimmunity and Immunoregulationmentioning

confidence: 99%

Autoimmunity and pulmonary hypertension: a perspective

Nicolls¹

2005

Eur Respir J

239

185

View full text Add to dashboard Cite

The association between autoimmunity and pulmonary arterial hypertension (PAH) has been appreciated for .40 yrs, but how autoimmune injury might contribute to the pathogenesis of this disease has only been examined in a case-specific manner.It is becoming increasingly clear that a variety of diverse clinical diseases, ranging from viral infections to connective tissue disorders, can culminate in pulmonary vascular pathology that is indistinguishable. Is there a hitherto unappreciated biology that unites these seemingly unrelated conditions?The answer to this question may come from the increasing body of evidence concerned with the central importance of regulatory T-cells in preventing inappropriate B-cell activity. Two striking similarities between conditions associated with severe angioproliferative pulmonary hypertension are a defect in the CD4 T-cell compartment and auto-antibody production. Pathogenic autoantibodies targeting endothelial cells are capable of inducing vascular endothelial apoptosis and may initiate the development of PAH.The present review will focus on what is known about autoimmune phenomena in pulmonary arterial hypertension patients, in order to better consider whether an early loss of self-tolerance followed by autoimmune injury could influence the early development of severe angioproliferative pulmonary hypertension.

show abstract

“…Splenectomy is widely performed for treating various hematological and non-hematological conditions [1][2][3][4][5][6]. There are debates as to whether there is increased risk of pulmonary arterial hypertension (PAH) following splenectomy either as a result of increased thromboembolism [7] or due -tion function [8].…”

Section: Introductionmentioning

confidence: 99%

Pulmonary hypertension in patients with hematological disorders following splenectomy

Ghosh

Meera²,

Jijina³

2009

Indian J Hematol Blood Transfus

View full text Add to dashboard Cite

Prevalence of pulmonary arterial hypertension (PAH) was studied by Echocardiography and Doppler in 43 splenectomised patients with various disorders 1-20 years after splenectomy. PAH was detected only in thalassemia -brosis groups comprising a total of 21 patients. Six patients out of 21 was found to have PAH with mean pulmonary arterial pressure of 46.28 ± 28.17 mmHg. Twenty one controls having similar duration and type of disease also were assessed for PAH in this case control study 3/21 had PAH in this control group. The difference in number of patients showing pulmonary hypertension between case and control though the difference in pulmonary arterial pressure bep<0.0029) with control group showing a mean pulmonary arterial pressure of 25 ± 19 mmHg.Platelet count in the splenectomised group was signifwith and without splenectomy. Patients undergoing splenectomy due to trauma, immune thrombocytopenia, sideroblastic anemia, extra hepatic portal hypertension, autoimmune hemolytic anemia did not show PAH after splenectomy even years after the procedure PAH following splenectomy is common after certain disorders and control patients with these diseases have tendency to develop PAH even without splenectomy. Pulmonary thromboembolism may be an important pathophysiological mechanism leading to this -brosis should have regular evaluation of pulmonary arterial pressure whether he/she has been splenectomised or not. This is particularly important as availability of phosphothese cases.

show abstract

Pulmonary Hypertension after Splenectomy?

Abstract: Patients who have had splenectomy may be at increased risk for developing pulmonary hypertension.

Cited by 154 publications

References 8 publications

Prognostic and aetiological factors in chronic thromboembolic pulmonary hypertension

Prognostic and aetiological factors in chronic thromboembolic pulmonary hypertension

Autoimmunity and pulmonary hypertension: a perspective

Pulmonary hypertension in patients with hematological disorders following splenectomy

Contact Info

Product

Resources

About