Pulmonary Hypertension, Hyperthyroidism, and Fenfluramine: A Case Report and Review

Leung Ying Ying, MBChB, FHKAM; Tang Kam Shing, MBBS, FHKAM; Tsang Chiu Chi, MBBS, FHKAM; Chan Chi Kin, FRCP, FHKAM; Wong Kwan Keung, FRCP, FHKAM; Yu Alex Wai-yin, FRCP, FACP, MD

Disclosures

November 08, 2006

Abstract and Introduction

Abstract

We report a case of pulmonary hypertension presenting with sudden cardiac arrest, hyperthyroidism and fenfluramine usage. This fatal case of pulmonary hypertension and valvular heart disease is associated with the use of an anorectic drug that had been withdrawn from the market more than eight years ago. Clinicians should alert to the side effects of appetite suppressant and slimming agents. The association between pulmonary hypertension in relation to hyperthyroidism and fenfluramine usage is reviewed.

Introduction

Pulmonary arterial hypertension (PAH) associated with fenfluramine is well documented, and its association with hyperthyroidism has been described. We report a case of pulmonary hypertension presenting with sudden cardiac arrest that was associated with both hyperthyroidism and fenfluramine usage.

References

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Cite this: Pulmonary Hypertension, Hyperthyroidism, and Fenfluramine: A Case Report and Review - Medscape - Nov 10, 2006.

Table 1. WHO Classification of Pulmonary Hypertension^[2]
1. Pulmonary arterial hypertension (PAH)
Sporadic (idiopathic PAH) Familial PAH Association with: Collagen vascular disease Congenital systemic-to-pulmonary shunts Portal hypertension HIV infection Drugs and toxins Other: hemoglobinopathies, etc. PAH with significant venous or capillary involvement Pulmonary veno-occlusive disease Pulmonary capillary hemangiomatosis Persistent pulmonary hypertension of the newborn
2. Pulmonary venous hypertension
3. Pulmonary hypertension associated with hypoxemia Chronic obstructive pulmonary disease Interstitial lung disease Sleep-disordered breathing Alveolar hypoventilation disorders Chronic exposure to high altitudes Developmental abnormalities
4. Pulmonary hypertension due to chronic thrombotic and/or embolic disease
5. Miscellaneous: Sarcoidosis, histiocytosis X, etc.

WHO = World Health Organization

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