Hostname: page-component-cd9895bd7-dzt6s Total loading time: 0 Render date: 2024-12-26T18:35:20.489Z Has data issue: false hasContentIssue false

Rapidly progressive pulmonary veno-occlusive disease in an infant with Down syndrome

Published online by Cambridge University Press:  27 March 2017

Jun Muneuchi*
Affiliation:
Department of Pediatrics, Japan Community Healthcare Organization Kyushu Hospital, Kitakyushu, Japan
Shinichiro Oda
Affiliation:
Department of Cardiovascular Surgery, Japan Community Healthcare Organization Kyushu Hospital, Kitakyushu, Japan
Daisuke Shimizu
Affiliation:
Department of Pediatrics, Japan Community Healthcare Organization Kyushu Hospital, Kitakyushu, Japan
*
Correspondence to: J. Muneuchi, MD, Department of Pediatrics, Japan Community Healthcare Organization Kyushu Hospital, 1-8-1, Kishinoura, Yahatanishi-ku, Fukuoka 806-8501, Japan. Tel: +81 93 641 5111; Fax: +81 93 642 1868; E-mail: jmun@msn.com

Abstract

A 4-month-old girl with Down syndrome showed unexpected deterioration of pulmonary hypertension. Despite aggressive pulmonary vasodilation therapy, the patient died at 5 months of age. Lung autopsy showed that the pulmonary veins were obliterated by intimal fibrous thickening, and the media of the veins was arterialised with an increase in elastic fibres. Pulmonary veno-occlusive disease should be considered in the management of individuals with Down syndrome.

Type
Brief Report
Copyright
© Cambridge University Press 2017 

Access options

Get access to the full version of this content by using one of the access options below. (Log in options will check for institutional or personal access. Content may require purchase if you do not have access.)

References

1. King, P, Tulloh, R. Management of pulmonary hypertension and Down syndrome. Int J Clin Pract Suppl 2011; 174: 813.CrossRefGoogle Scholar
2. Cooney, TP, Thurlbeck, WM. Pulmonary hypoplasia in Down’s syndrome. N Engl J Med 1982; 307: 11701173.Google Scholar
3. Yamaki, S, Horiuchi, T, Sekine, Y. Quantitative analysis of pulmonary vascular disease in simple cardiac anomalies with the Down syndrome. Am J Cardiol 1983; 51: 15021506.CrossRefGoogle ScholarPubMed
4. de Miguel-Diez, J, Villa-Asensi, JR, Alvarez-Sala, JL. Prevalence of sleep-disordered breathing in children with Down syndrome: polygraphic findings in 108 children. Sleep 2003; 26: 10061009.CrossRefGoogle ScholarPubMed
5. Cua, CL, Rogers, LK, Chicoine, LG, et al. Down syndrome patients with pulmonary hypertension have elevated plasma levels of asymmetric dimethylarginine. Eur J Pediatr 2011; 170: 859863.CrossRefGoogle ScholarPubMed
6. Fukushima, H, Kosaki, K, Sato, R, et al. Mechanisms underlying early development of pulmonary vascular obstructive disease in Down syndrome: an imbalance in biosynthesis of thromboxane A2 and prostacyclin. Am J Med Genet A. 2010; 152: 19191924.Google Scholar
7. Montani, D, Lau, EM, Dorfmüller, P, et al. Pulmonary veno-occlusive disease. Eur Respir J. 2016; 47: 15181534.Google Scholar
8. Yang, Q, Rasmussen, SA, Friedman, JM. Mortality associated with Down’s syndrome in the USA from 1983 to 1997: a population-based study. Lancet 2002; 359: 10191025.CrossRefGoogle ScholarPubMed
9. Woerner, C, Cutz, E, Yoo, SJ, Grasemann, H, Humpl, T. Pulmonary venoocclusive disease in childhood. Chest 2014; 146: 167174.Google Scholar
10. Günther, S, Jaïs, X, Maitre, S, et al. Computed tomography findings of pulmonary venoocclusive disease in scleroderma patients presenting with precapillary pulmonary hypertension. Arthritis Rheum 2012; 64: 29953005.CrossRefGoogle ScholarPubMed