Successful switch from inhalative iloprost to oral bosentan in portopulmonary hypertension associated with liver cirrhosis

被引:19
作者
Molnar, C
Alber, H
Colleselli, D
Vogel, W
Kähler, CM
机构
[1] Innsbruck Med Univ, Serv Pneumol, Clin Dept Internal Med, Clin Div Gen Internal Med, A-6020 Innsbruck, Austria
[2] Innsbruck Med Univ, Clin Div Cardiol, A-6020 Innsbruck, Austria
[3] Innsbruck Med Univ, Clin Div Gastroenterol, Clin Dept Internal Med, A-6020 Innsbruck, Austria
关键词
cirrhosis; bosentan; iloprost; liver transplantation; liver cirrhosis; pulmonary hypertension;
D O I
10.1007/s00508-004-0238-2
中图分类号
R5 [内科学];
学科分类号
1002 ; 100201 ;
摘要
Portopulmonary hypertension (PPHTN) is a rare complication of liver cirrhosis. Prostanoids have been shown to be effective in the treatment of PPHTN and have been used as a bridge to orthotopic liver transplantation. However, inhibition of platelet aggregation might be a limitation of prostacyclin therapy in patients with end-stage liver disease having an increased risk of bleeding from esophageal varices. The effect of oral bosentan, a dual endothelin-receptor antagonist in the reversal of PPHTN, is still unclear. We report a case of PPHTN (mean pulmonary artery pressure [mPAP] of 51 mmHg) that was successfully switched from inhalative iloprost to oral bosentan therapy. Hemodynamic and symptomatic improvements were maintained after a 12-month long-term treatment with inhalative iloprost as well as after single oral bosentan therapy. This is the first reported case of a successful switch from therapy with an inhalative prostacyclin analogue to oral bosentan in a patient suffering from PPHTN. Thus, oral bosentan therapy might be a promising new option for patients suffering from PPHTN.
引用
收藏
页码:627 / 630
页数:6
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