Pulmonary Hypertension

Today we discussed pulmonary hypertension.  Here are some follow up articles

First, see this post (though it is a bit old it touches on key points we discussed today and has some references)
http://internalvalidity.blogspot.ca/2008/12/day-144-pulmonary-hypertension.html

Pleural effusions due to right heart failure and pulmonary hypertension?
 
Pleural effusions without other clear cause are common in PH
http://www-ncbi-nlm-nih-gov.proxy3.library.mcgill.ca/pubmed/21623177

Here is another article stating the same thing, written by Dr. LIGHT (i.e. light's criteria for exudate vs transudate fame)!   The majority are UNILATERAL (60%) and small (63%)
http://www-ncbi-nlm-nih-gov.proxy3.library.mcgill.ca/pubmed/19395582

This is especially true in collagen vascular disease associated PH
http://www-ncbi-nlm-nih-gov.proxy3.library.mcgill.ca/pubmed/21212140

What is the value of CT thorax in these patients?
 
An interesting review of the value of CT thorax in PH in terms of associated findings is here:
http://www-ncbi-nlm-nih-gov.proxy3.library.mcgill.ca/pubmed/25523307

Referral to specialized clinics may be associated with better outcomes

http://www-ncbi-nlm-nih-gov.proxy3.library.mcgill.ca/pubmed/23568223

Associated editorial:
http://www-ncbi-nlm-nih-gov.proxy3.library.mcgill.ca/pubmed/23568571


Finally, should we be more optimistic about the role of calcium channel blockers than I was in 2008?
 
The role of Calcium Channel Blockers in PH therapy is reviewed here
http://www-ncbi-nlm-nih-gov.proxy3.library.mcgill.ca/pubmed/25666253

Case of the Week -- TTP

Please see previous post on Thrombotic Thrombocytopenic Purpura (TTP):
http://internalvalidity.blogspot.ca/2008/10/day-110-ttp.html

The ORIGINAL CASE REPORT by MOSCHCOWITZ in 1925 Archives of Internal medicine!
http://archinte.jamanetwork.com.proxy3.library.mcgill.ca/article.aspx?articleid=534853

2006 NEJM Review of the topic:

http://www.nejm.org/doi/full/10.1056/NEJMcp053024

Classic FFP in TTP paper (FFP is better than nothing):

http://www.nejm.org.proxy3.library.mcgill.ca/doi/full/10.1056/NEJM197712222972507

The Classic PLEX is better than FFP paper:

http://www.nejm.org/doi/full/10.1056/NEJM199108083250604

Drug-induced TTP:

http://www.ncbi.nlm.nih.gov/pubmed/25414441

HIV presenting as TTP (I've seen two!):

http://www.ncbi.nlm.nih.gov/pubmed/7926980

Risk of relapse in TTP:

http://www.ncbi.nlm.nih.gov/pubmed/7887549

Bonus -- approach to hemolytic anemia from my CMR teaching deck

http://chiefmedicalresident.blogspot.ca/2008/08/day-39-anemia.html

CIDP in Renal Transplant

Great case presented today

Here is the relevant reading:

Caused by tacrolimus:
http://www-ncbi-nlm-nih-gov.proxy3.library.mcgill.ca/pubmed/25874089

Case series in solid organ transplant:
http://www-ncbi-nlm-nih-gov.proxy3.library.mcgill.ca/pubmed/22577230

Due to CMV:
http://www-ncbi-nlm-nih-gov.proxy3.library.mcgill.ca/pubmed/10489240

Review of drug induced CIDP and other similar neuropathies (mentions tacro!):
http://www-ncbi-nlm-nih-gov.proxy3.library.mcgill.ca/pubmed/12352008