Laboratory_evaluation
Laboratory evaluation is mandatory with respect to HIV disease (9, 10) and thyroid disorders (ultrasensitive TSH assay) (11). Genetic testing is still experimental (12).
Autoantibody testing should be performed only if collagen vascular disease is supected on clinical grounds:
Antinuclear antibodies are nonspecific since they are present in up to one third of the patients with PPH (3).
The presence of liver cirrhosis is suggested by hematologic abnormalities (macrocytosis, thrombocytopenia), electrophoresis (hypalbuminemia, hypergammaglobulinemia) and morphologic changes on ultrasound or computed tomography. Screening for possible chronic hepatitis (hepatitis S antigen, anti-HBc-IgM, anti-hepatitis C antibodies) may be indicated. Overall liver function can be assessed by determining factor V levels which reflects liver function even in anticoagulated patients. Elevated bilirubin levels greater than 36 µmol/l are indicative of severe cardiac cirrhosis and associated with poor survival after lung transplantation (13).
Autoantibody testing should be performed only if collagen vascular disease is supected on clinical grounds:
- Anti-Scl-70 antibodies for progressive systemic sclerosis of diffuse type
- Anti-centromere antibodies and for progressive systemic sclerosis of cutaneous limited type
- Anti-U1-snRNP for mixed connective tissue disease
- Anti-Jo-1 for polymyositis/dermatomyositis
- Anti-dsDNA and anti-SM for systemic lupus erythematosus
- Rheumatoid factor for rheumatoid arthritis.
Antinuclear antibodies are nonspecific since they are present in up to one third of the patients with PPH (3).
The presence of liver cirrhosis is suggested by hematologic abnormalities (macrocytosis, thrombocytopenia), electrophoresis (hypalbuminemia, hypergammaglobulinemia) and morphologic changes on ultrasound or computed tomography. Screening for possible chronic hepatitis (hepatitis S antigen, anti-HBc-IgM, anti-hepatitis C antibodies) may be indicated. Overall liver function can be assessed by determining factor V levels which reflects liver function even in anticoagulated patients. Elevated bilirubin levels greater than 36 µmol/l are indicative of severe cardiac cirrhosis and associated with poor survival after lung transplantation (13).
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5th International Congress of the Swiss Society of Pulmonary Hypertension (SSPH)
28.-29. September 2012, Thun, Congress Hotel Seepark Thun
Informationen: www.imk.ch/sgph2012
SSPH Research Prize 2012
Deadline for submission: April 30, 2012
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