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Drug-induced pulmonary arterial hypertension: a recent outbreak

David Montani, Andrei Seferian, Laurent Savale, Gérald Simonneau, Marc Humbert
European Respiratory Review 2013 22: 244-250; DOI: 10.1183/09059180.00003313
David Montani
1Université Paris-Sud, Le Kremlin-Bicêtre, 2AP-HP, Service de Pneumologie, TORINO Thorax Innovation, Hôpital Bicêtre, Le Kremlin-Bicêtre, and 3INSERM U999, LabEx LERMIT, Centre Chirurgical Marie Lannelongue, Le Plessis Robinson, France
1Université Paris-Sud, Le Kremlin-Bicêtre, 2AP-HP, Service de Pneumologie, TORINO Thorax Innovation, Hôpital Bicêtre, Le Kremlin-Bicêtre, and 3INSERM U999, LabEx LERMIT, Centre Chirurgical Marie Lannelongue, Le Plessis Robinson, France
1Université Paris-Sud, Le Kremlin-Bicêtre, 2AP-HP, Service de Pneumologie, TORINO Thorax Innovation, Hôpital Bicêtre, Le Kremlin-Bicêtre, and 3INSERM U999, LabEx LERMIT, Centre Chirurgical Marie Lannelongue, Le Plessis Robinson, France
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  • For correspondence: david.montani@bct.aphp.fr
Andrei Seferian
1Université Paris-Sud, Le Kremlin-Bicêtre, 2AP-HP, Service de Pneumologie, TORINO Thorax Innovation, Hôpital Bicêtre, Le Kremlin-Bicêtre, and 3INSERM U999, LabEx LERMIT, Centre Chirurgical Marie Lannelongue, Le Plessis Robinson, France
1Université Paris-Sud, Le Kremlin-Bicêtre, 2AP-HP, Service de Pneumologie, TORINO Thorax Innovation, Hôpital Bicêtre, Le Kremlin-Bicêtre, and 3INSERM U999, LabEx LERMIT, Centre Chirurgical Marie Lannelongue, Le Plessis Robinson, France
1Université Paris-Sud, Le Kremlin-Bicêtre, 2AP-HP, Service de Pneumologie, TORINO Thorax Innovation, Hôpital Bicêtre, Le Kremlin-Bicêtre, and 3INSERM U999, LabEx LERMIT, Centre Chirurgical Marie Lannelongue, Le Plessis Robinson, France
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Laurent Savale
1Université Paris-Sud, Le Kremlin-Bicêtre, 2AP-HP, Service de Pneumologie, TORINO Thorax Innovation, Hôpital Bicêtre, Le Kremlin-Bicêtre, and 3INSERM U999, LabEx LERMIT, Centre Chirurgical Marie Lannelongue, Le Plessis Robinson, France
1Université Paris-Sud, Le Kremlin-Bicêtre, 2AP-HP, Service de Pneumologie, TORINO Thorax Innovation, Hôpital Bicêtre, Le Kremlin-Bicêtre, and 3INSERM U999, LabEx LERMIT, Centre Chirurgical Marie Lannelongue, Le Plessis Robinson, France
1Université Paris-Sud, Le Kremlin-Bicêtre, 2AP-HP, Service de Pneumologie, TORINO Thorax Innovation, Hôpital Bicêtre, Le Kremlin-Bicêtre, and 3INSERM U999, LabEx LERMIT, Centre Chirurgical Marie Lannelongue, Le Plessis Robinson, France
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Gérald Simonneau
1Université Paris-Sud, Le Kremlin-Bicêtre, 2AP-HP, Service de Pneumologie, TORINO Thorax Innovation, Hôpital Bicêtre, Le Kremlin-Bicêtre, and 3INSERM U999, LabEx LERMIT, Centre Chirurgical Marie Lannelongue, Le Plessis Robinson, France
1Université Paris-Sud, Le Kremlin-Bicêtre, 2AP-HP, Service de Pneumologie, TORINO Thorax Innovation, Hôpital Bicêtre, Le Kremlin-Bicêtre, and 3INSERM U999, LabEx LERMIT, Centre Chirurgical Marie Lannelongue, Le Plessis Robinson, France
1Université Paris-Sud, Le Kremlin-Bicêtre, 2AP-HP, Service de Pneumologie, TORINO Thorax Innovation, Hôpital Bicêtre, Le Kremlin-Bicêtre, and 3INSERM U999, LabEx LERMIT, Centre Chirurgical Marie Lannelongue, Le Plessis Robinson, France
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Marc Humbert
1Université Paris-Sud, Le Kremlin-Bicêtre, 2AP-HP, Service de Pneumologie, TORINO Thorax Innovation, Hôpital Bicêtre, Le Kremlin-Bicêtre, and 3INSERM U999, LabEx LERMIT, Centre Chirurgical Marie Lannelongue, Le Plessis Robinson, France
1Université Paris-Sud, Le Kremlin-Bicêtre, 2AP-HP, Service de Pneumologie, TORINO Thorax Innovation, Hôpital Bicêtre, Le Kremlin-Bicêtre, and 3INSERM U999, LabEx LERMIT, Centre Chirurgical Marie Lannelongue, Le Plessis Robinson, France
1Université Paris-Sud, Le Kremlin-Bicêtre, 2AP-HP, Service de Pneumologie, TORINO Thorax Innovation, Hôpital Bicêtre, Le Kremlin-Bicêtre, and 3INSERM U999, LabEx LERMIT, Centre Chirurgical Marie Lannelongue, Le Plessis Robinson, France
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Tables

  • Additional Files
  • Table 1. Updated clinical classification of pulmonary hypertension
    1. Pulmonary arterial hypertension
        1.1 Idiopathic pulmonary arterial hypertension
        1.2 Heritable
            1.2.1. BMPR2
            1.2.2. ALK1, endoglin (with or without hereditary haemorrhagic telangiectasia)
            1.2.3 Unknown
        1.3 Drug- and toxin-induced
        1.4 Associated with:
            1.4.1 Connective tissue diseases
            1.4.2 HIV infection
            1.4.3 Portal hypertension
            1.4.4 Congenital heart diseases
            1.4.5 Schistosomiasis
            1.4.6 Chronic haemolytic anaemia
        1.5 Persistent pulmonary hypertension of the newborn
    1'. Pulmonary veno-occlusive disease and/or pulmonary capillary haemangiomatosis
    2. Pulmonary hypertension due to left heart disease
        2.1 Systolic dysfunction
        2.2 Diastolic dysfunction
        2.3 Valvular disease
    3. Pulmonary hypertension due to lung diseases and/or hypoxia
        3.1 Chronic obstructive pulmonary disease
        3.2 Interstitial lung disease
        3.3 Other pulmonary diseases with mixed restrictive and obstructive pattern
        3.4 Sleep-disordered breathing
        3.5 Alveolar hypoventilation disorders
        3.6 Chronic exposure to high altitude
        3.7 Developmental abnormalities
    4. Chronic thromboembolic pulmonary hypertension
    5. Pulmonary hypertension with unclear and/or multifactorial mechanisms
        5.1 Haematological disorders: myeloproliferative disorders splenectomy
        5.2 Systemic disorders, sarcoidosis, pulmonary Langerhans cell histiocytosis, lymphangioleiomyomatosis, neurofibromatosis, vasculitis
        5.3 Metabolic disorders: glycogen storage disease, Gaucher disease, thyroid disorders
        5.4 Others: tumoural obstruction, fibrosing mediastinitis, chronic renal failure on dialysis
    • BMPR2: bone morphogenetic protein receptor, type II; ALK1: activin receptor-like kinase 1 gene. Reproduced from [2] with permission from the publisher.

  • Table 2. Risk factors for and associated conditions of pulmonary arterial hypertension
    DefinitePossible
        Aminorex    Cocaine
        Fenfluramine    Phenylpropanolamine
        Dexfenfluramine    St John's Wort
        Toxic rapeseed oil    Chemotherapeutic agents
        Benfluorex    Selective serotonin reuptake inhibitors
        Dasatinib    Pergolide
    LikelyUnlikely
        Amphetamines    Oral contraceptives
        L-Tryptophan    Oestrogen
        Methamphetamines    Cigarette smoking
    • Reproduced and modified from [5].

Additional Files

  • Tables
  • Disclosures

    Files in this Data Supplement:

    • M. Humbert
    • D. Montani
    • L. Savale
    • G. Simonneau
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Drug-induced pulmonary arterial hypertension: a recent outbreak
David Montani, Andrei Seferian, Laurent Savale, Gérald Simonneau, Marc Humbert
European Respiratory Review Sep 2013, 22 (129) 244-250; DOI: 10.1183/09059180.00003313

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Drug-induced pulmonary arterial hypertension: a recent outbreak
David Montani, Andrei Seferian, Laurent Savale, Gérald Simonneau, Marc Humbert
European Respiratory Review Sep 2013, 22 (129) 244-250; DOI: 10.1183/09059180.00003313
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