Abstract
A 43-year-old man presented with dyspnea on exertion. Right heart catheterization demonstrated pulmonary arterial hypertension (PAH). He was treated with bosentan, sildenafil and intravenous epoprostenol. Despite the administration of such intensive therapy, the patient's condition deteriorated to a World Health Organization functional class (WHO-FC) of IV. He participated in a clinical trial of imatinib for PAH. After three months of treatment with imatinib, the chest X-ray and echocardiography findings improved, and the WHO-FC class was III. One year after, however, the PAH worsened again, and the patient died 2.6 years after the first diagnosis. At autopsy, patchy capillary proliferation was observed in the lungs. The definitive diagnosis was pulmonary capillary hemangiomatosis.
MeSH terms
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Adult
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Antihypertensive Agents / therapeutic use*
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Antineoplastic Agents / administration & dosage*
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Autopsy
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Benzamides / administration & dosage*
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Bosentan
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Cardiac Catheterization
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Dyspnea / etiology
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Echocardiography
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Epoprostenol / administration & dosage
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Fatal Outcome
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Hemangioma, Capillary / diagnosis*
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Hemangioma, Capillary / drug therapy*
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Hemangioma, Capillary / pathology
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Hemangioma, Capillary / physiopathology
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Humans
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Hypertension, Pulmonary / complications*
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Hypertension, Pulmonary / drug therapy
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Imatinib Mesylate
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Lung / pathology*
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Lung / physiopathology
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Lung Neoplasms / diagnosis*
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Lung Neoplasms / drug therapy*
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Lung Neoplasms / pathology
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Lung Neoplasms / physiopathology
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Male
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Piperazines / administration & dosage*
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Purines / administration & dosage
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Pyrimidines / administration & dosage*
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Radiography, Thoracic
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Sildenafil Citrate
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Sulfonamides / administration & dosage
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Treatment Failure
Substances
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Antihypertensive Agents
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Antineoplastic Agents
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Benzamides
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Piperazines
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Purines
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Pyrimidines
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Sulfonamides
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Imatinib Mesylate
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Sildenafil Citrate
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Epoprostenol
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Bosentan