Pulmonary arterial hypertension in an 80-year-old man with long-term use of cyclophosphamide

Takatoshi Suzuki; Ichizo Tsujino; Wataru Harabayashi; Hideki Shima; Junichi Nakamura; Takahiro Sato; Masaru Suzuki; Yukari Takeda; Satohi Konno

doi:10.1016/j.rmcr.2023.101867

Pulmonary arterial hypertension in an 80-year-old man with long-term use of cyclophosphamide

Respir Med Case Rep. 2023 May 11:44:101867. doi: 10.1016/j.rmcr.2023.101867. eCollection 2023.

Authors

Takatoshi Suzuki¹, Ichizo Tsujino¹, Wataru Harabayashi¹, Hideki Shima¹, Junichi Nakamura¹, Takahiro Sato¹, Masaru Suzuki¹, Yukari Takeda², Satohi Konno¹

Affiliations

¹ Department of Respiratory Medicine, Faculty of Medicine, Hokkaido University, N15, W7, Kita-ku, Sapporo, 060-8638, Japan.
² Department of Hematology, Tonan Hospital, N4, W7, Kita-ku, Sapporo, 060-0004, Japan.

Abstract

An 80-year-old man diagnosed with primary macroglobulinemia 7 years earlier had been treated with cyclophosphamide, following which he developed dyspnea on exertion. Cyclophosphamide was discontinued. The patient's dyspnea, however, failed to improve. Right heart catheterization (RHC) revealed precapillary pulmonary hypertension (PH). He was transferred to our institution for further examination. Prior use of cyclophosphamide was the patient's only risk factor for PH, and cyclophosphamide use was considered as a possible cause of PH in this case. He was treated with tadalafil and dyspnea gradually improved. A follow-up RHC exhibited improvement in mean pulmonary arterial pressure and pulmonary vascular resistance.

Keywords: Cyclophosphamide; Primary macroglobulinemia; Pulmonary arterial hypertension.

Publication types

Case Reports