To the Editors:
Pulmonary arterial hypertension (PAH) is a serious disease. New treatments have favourably changed the prognosis. Its frequent association with autoimmune thyroid disease (ATD) has been previously acknowledged 1–3. ATD may also be associated with other autoimmune diseases. Here, we report two cases of PAH associated with type II autoimmune polyglandular syndrome (APS).
In the first case, a 50-yr-old female was diagnosed with idiopathic PAH (dyspnoea on exertion, angina, and mean pulmonary arterial pressure (mPAP) determined by right catheterisation 6.38 kPa (48 mmHg)). Slightly high levels of thyrotropin (TSH) were detected, with normal free thyroxine (FT4) levels, and high serum concentrations of anti-thyroglobulin and anti-thyroid peroxidase antibodies. She improved with i.v. epoprostenol, although it was later necessary to add sildenafil and bosentan. In October 2003, a goitre appeared. Levels of TSH and FT4 were normal. Scintigraphy showed a diffuse goitre without …
