Chemotherapy Improved Pulmonary Arterial Hypertension in a Patient with Chronic-Active Epstein-Barr Virus Infection.

Abstract

Chronic-active Epstein-Barr virus infection (CAEBV) is a rare disease that can lead to pulmonary arterial hypertension (PAH). However, the treatment for CAEBV-associated PAH has not been established. We discuss a case of improved pulmonary hypertension after chemotherapy in a patient with CAEBV-associated PAH. A 44-year old man was admitted to our hospital because of an abnormal electrocardiogram and liver dysfunction detected by annual medical examination. Echocardiography showed a dilated right ventricle and an estimated right ventricular systolic pressure of 92 mmHg. Right heart catheterization revealed a mean pulmonary arterial pressure of 45 mmHg and pulmonary vascular resistance of 9.8 Wood units. Laboratory examination showed granular lymphocytes and 91% natural killer cells in lymphocyte subsets in peripheral blood. We diagnosed the patient as having CAEBV-associated PAH. After two cycles of chemotherapy without PAH-specific drugs, echocardiography showed improvement in the dilated right ventricle and an estimated right ventricular systolic pressure of 59 mmHg. Right heart catheterization revealed a mean pulmonary arterial pressure of 27 mmHg and pulmonary vascular resistance of 2.4 Wood units. Chemotherapy may improve pulmonary hypertension in patients with CAEBV-associated PAH.

• Authors: Satoshi Akagi, Takashi Miki, Yasuhisa Sando, Nobuharu Fujii, Toshihiro Sarashina, Kazufumi Nakamura, Hiroshi Ito
• Journal: International heart journal (Int Heart J) Vol. 61 Issue 1 Pg. 191-194 (Jan 31 2020) ISSN: 1349-3299 [Electronic] Japan
• PMID: 31956153 (Publication Type: Case Reports, Journal Article)

Topics

• Adult
• Cardiac Catheterization
• Drug Therapy
• Echocardiography
• Epstein-Barr Virus Infections (complications, drug therapy)
• Humans
• Male
• Pulmonary Arterial Hypertension (diagnosis, drug therapy, etiology)
• Treatment Outcome