Sickle cell disease related chronic thromboembolic pulmonary hypertension: challenging clinical scenario

J Thromb Thrombolysis. 2022 Feb;53(2):467-470. doi: 10.1007/s11239-021-02483-7. Epub 2021 May 27.

Abstract

Sickle cell disease (SCD), a haemoglobinopathy characterized by chronic haemolysis with acute exacerbations and vascular occlusion episodes, may be complicated by pulmonary hypertension. The latter may be caused by chronic thromboembolic disease of pulmonary artery branches and its management is not well-defined. Herein, we present a case of SCD complicated by chronic thromboembolic pulmonary hypertension of subsegmental pulmonary artery branches successfully treated with endothelin receptor antagonists, orally administered prostacyclin analogs and balloon pulmonary angioplasty. This challenging case highlights the need for clinical awareness of chronic thromboembolic pulmonary hypertension as a specific and potentially curable form of pulmonary hypertension complicating SCD course that may necessitate combined pharmacologic and interventional management.

Keywords: Balloon pulmonary angioplasty; Chronic thromboembolic pulmonary hypertension; Endothelin receptor antagonist; Oral prostacyclin agonist; Sickle cell disease.

Publication types

  • Case Reports

MeSH terms

  • Anemia, Sickle Cell* / complications
  • Angioplasty, Balloon* / adverse effects
  • Chronic Disease
  • Humans
  • Hypertension, Pulmonary* / diagnosis
  • Hypertension, Pulmonary* / etiology
  • Hypertension, Pulmonary* / surgery
  • Pulmonary Artery / surgery
  • Pulmonary Embolism* / complications
  • Pulmonary Embolism* / diagnosis