CASE REPORT
Pulmonary Langerhans cell histiocytosis-associated pulmonary hypertension Report of two cases
 
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1
Pulmonologist-Intensivist, 2nd Department of Critical Care, National and Kapodistrian University of Athens Medical School, Attikon Hospital, Athens, Greece
 
2
Radiologist, 2nd Department of Radiology, National and Kapodistrian University of Athens Medical School, Attikon Hospital, Athens, Greece
 
3
Professor of Critical Care, 2nd Department of Critical Care, Clinical Co-director of Pulmonary Hypertension Clinic,National and Kapodistrian University of Athens Medical School, Attikon Hospital, Athens, Greece
 
4
Cardiologist, 2nd Department of Cardiology, National and Kapodistrian University of Athens Medical School, Attikon Hospital, Athens, Greece
 
5
Cardiologist-Intensivist, 2nd Department of Critical Care,National and Kapodistrian University of Athens Medical School, Attikon Hospital, Athens, Greece
 
6
Clinical Nurse, 2nd Department of Critical Care and 2nd Department of Cardiology, National and Kapodistrian University of Athens Medical School, Attikon Hospital, Athens, Greece
 
7
Pulmonologist-Intensivist, Professor of Critical Care & Director of 2nd Department of Critical Care and Pulmonary Hypertension Clinic, National and Kapodistrian University of Athens Medical School, Attikon Hospital, Athens, Greece
 
 
Corresponding author
Aikaterini Flevari   

2nd Department of Critical Care, Attikon Hospital, 1 Rimini street, Haidari, 12462 Athens, Greece
 
 
Pneumon 2019;32(1-2):43-48
 
KEYWORDS
ABSTRACT
Langerhans cell histiocytosis (LCH) is a multisystemic disease affecting mainly the skeleton and the lungs. It is an uncommon interstitial lung disease whose radiological findings are characterized by centrilobular nodules and cysts of varying sizes of mid to upper lung distribution. Pulmonary LCH can be associated with pulmonary hypertension (PH) which is often severe. We report two cases with Pulmonary Langerhans cell histiocytocis who were referred to our pulmonary hypertension clinic because of echocardiographic signs of severe PH. Right heart catheterization confirmed the presence of precapillary PH in both patients; however in one patient the severity of PH was disproportional to lung disease, as revealed from pulmonary function tests and highresolution computed Tomography chest findings, suggesting pulmonary vascular involvement. We would like to emphasize the wide spectrum of Pulmonary LCH - associated PH and the rationale to treat some patients with specific PAH medication.
 
REFERENCES (12)
1.
Allen CE, Merad M, McClain KL. Langerhans-Cell Histiocytosis. New Engl J Med 2018;379:856-68.
 
2.
Wei P, Lu H-W, Jiang S, Fan L-C, Li H-P, Xu J-F. Pulmonary Langerhans Cell Histiocytosis: Case series and literature review. Medicine (Baltimore) 2014;93:e141.
 
3.
Harari S, Brenot F, Barberis M, Simmoneau G. Advanced pulmonary histiocytosis X is associated with severe pulmonary hypertension. Chest 1997;111:1142-4.
 
4.
MacNee W. Pathophysiology of cor pulmonale in chronic obstructive pulmonary disease. Part One. Am J Respir Crit Care Med 1994;150:833-52.
 
5.
Galiè N, Humbert M, Vachiery J-L, et al. 2015 ESC/ERS Guidelines for the diagnosis and treatment of pulmonary hypertension. Eur Respir J 2015;46:903-75.
 
6.
Fartoukh M, Humbert M, Capron F, et al. Severe pulmonary hypertension in histiocytosis X. Am J Respir Crit Care Med 2000;161:216-23.
 
7.
Chaowalit N, Pellikka PA, Decker PA, et al. Echocardiographic and Clinical Characteristics of Pulmonary Hypertension Complicating Pulmonary Langerhans Cell Histiocytosis. Mayo Clin Proc 2004;79:1269-75.
 
8.
Colby T, Lombard C. Histiocytosis X in the lung. Hum Pathol 1983;14:847-56.
 
9.
Crausman R, King TJ. Pulmonary vascular involvement in pulmonary histiocytosis X. Chest 1997:1714.
 
10.
Le Pavec J, Lorillon G, Jaïs X, et al. Pulmonary langerhans cell histiocytosis-associated pulmonary hypertension: Clinical characteristics and impact of pulmonary arterial hypertension therapies. Chest 2012;142:1150-57.
 
11.
Crausman RS, Jennings CA, Tuder RM, Ackerson LM, Irvin CG, King TEJ. Pulmonary histiocytosis X: pulmonary function and exercise pathophysiology. Am J Respir Crit Care Med 1996;153:426-35.
 
12.
May A, Kane G, Yi E, Frantz R, Vassallo R. Dramatic and sustained responsiveness of pulmonary Langerhans cell histiocytosisassociated pulmonary hypertension to vasodilator therapy. Respir Med Case Rep 2015;14:13-5.
 
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ISSN:1105-848X
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