[Reversible pulmonary hypertension in Basedow's disease].

BACKGROUND: An association between pulmonary hypertension and hyperthyroidism has been described. An autoimmune mechanism is usually advocated but a direct effect thyroid hormones on the pulmonary vascular system is also suggested. CASE REPORT: A 49-year-old woman with a history of Graves' disease was admitted for sudden dyspnea. There was no evidence of ischemic stroke and the electrocardiogram and cardiac enzymes were normal. The lung scintiscan did not show any sign of pulmonary embolism. The chest computed tomography was normal. Doppler echocardiography found pulmonary hypertension with systolic pulmonary artery pressure of 68.7 mmHg. Thyroid function tests showed hyperthyroidism with recurrent Graves' disease. Pulmonary hypertension markedly decreased after the euthyroid state was achieved with antithyroid therapy. DISCUSSION: This patient had pulmonary hypertension associated with hyperthyroidism due to Graves' disease. The rapid reversibility of pulmonary hypertension in this case after the achievement of the euthyroid state suggest a pathogenic link between these two disorders and a possible direct effect of thyroid hormones on the pulmonary vascular system.