Journal
PEDIATRIC PULMONOLOGY
Volume 57, Issue 5, Pages 1366-1369Publisher
WILEY
DOI: 10.1002/ppul.25877
Keywords
bone morphogenetic protein receptor type II; pulmonary arterial hypertension; pulmonary veno-occlusive disease; single living-donor lobar lung transplantation
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This study reported a case of a 29-month-old boy with PVOD and a novel BMPR2 gene variant associated with I/HPAH. This finding supports the concept that I/HPAH and PVOD are part of a spectrum of pulmonary vascular disease.
Pulmonary veno-occlusive disease (PVOD) and idiopathic/heritable pulmonary arterial hypertension (I/HPAH) cause progressive PH on the distinct genetic impact. A 29-month-old boy presented with a loss of consciousness. He had severe PH refractory to pulmonary vasodilators. Hypoxemia and ground-glass opacity on the chest computed tomography were present, and significant pulmonary edema developed after the introduction of continuous intravenous prostaglandin I-2. Based on the clinical diagnosis of PVOD, he underwent a single living-donor lobar lung transplantation with the right lower lobe of his mother. The pathological findings of his explanted lung showed intimal thickening and luminal narrowing of the pulmonary vein. A genetic test revealed a novel heterozygous splice acceptor variant (c.77-2A>C) in BMPR2, which is typically associated with I/HPAH. This is the first pediatric case of PVOD with BMPR2 variant, supporting the concept that I/HPAH and PVOD are part of a spectrum of pulmonary vascular disease.
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