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Nontuberculous mycobacterium diseases and chronic thromboembolic pulmonary hypertension.
- Source :
-
Internal medicine (Tokyo, Japan) [Intern Med] 2014; Vol. 53 (20), pp. 2273-9. Date of Electronic Publication: 2014 Oct 15. - Publication Year :
- 2014
-
Abstract
- Objective: We aimed to investigate the incidence and clinical characteristics of nontuberculous mycobacterial (NTM) pulmonary disease as a complication of chronic thromboembolic pulmonary hypertension (CTEPH).<br />Methods: We conducted a retrospective study of 10 cases (5.6%) complicated by NTM pulmonary disease among 180 CTEPH patients.<br />Results: Isolated species of avium (n=5), kansasii (n=2), intracellulare (n=1), abscessus (n=1) and fortuitum (n=1) were detected. NTM-infected lesions were observed in 33 of 180 (18.3%) lung segments obtained from the 10 patients, and complete obstruction due to chronic pulmonary thromboembolism was detected in 65 of the 180 segmental pulmonary arteries (36.1%). The NTM-infected segments in the CTEPH patients were significantly associated with obstructed rather than unobstructed pulmonary artery segments [25 of 65 (38.5%) vs. 8 of 115 (6.9%), p<0.01]. Cavitary, nodular, ectatic and ground-glass lesions were seen in 14, 22, seven and four of the 180 segments, respectively. Thirteen of the 14 cavitary (92.9%) lesions were located in non-perfused segments. Five patients with NTM disease underwent pulmonary endarterectomy (PEA). Of the 18 assessable NTM-infected segments in six NTM-treated patients, 17 were located in non-perfused segments and one was located in a previously perfused segment. All NTM-infected segments improved among three segments reperfused with PEA. In contrast, only eight (57.1%) NTM-infected segments improved among 14 continuously non-perfused segments. A lower body mass index was found to be a significant risk factor for NTM disease in the CTEPH patients.<br />Conclusion: This is the first report to document NTM-disease complications in patients with CTEPH. Reperfusion in cases of NTM lesions may improve the response to NTM drug therapy.
- Subjects :
- Adolescent
Adult
Aged
Chronic Disease
Endarterectomy
Female
Humans
Male
Middle Aged
Nontuberculous Mycobacteria
Pulmonary Artery
Pulmonary Embolism surgery
Retrospective Studies
Risk Factors
Young Adult
Hypertension, Pulmonary complications
Mycobacterium Infections, Nontuberculous complications
Pulmonary Embolism complications
Subjects
Details
- Language :
- English
- ISSN :
- 1349-7235
- Volume :
- 53
- Issue :
- 20
- Database :
- MEDLINE
- Journal :
- Internal medicine (Tokyo, Japan)
- Publication Type :
- Academic Journal
- Accession number :
- 25318788
- Full Text :
- https://doi.org/10.2169/internalmedicine.53.2558