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To the Editor: In a recent Grand Rounds, Dr Gaine¹ discussed a 44-year-old woman with primary pulmonary hypertension (PPH). After extensive investigations he associated her PPH with anorexigen use. However no information was provided on clinical or laboratory features of thyroid disease. An association between hypothyroidism and PPH has been reported. Curnock et al² carried out a retrospective review of 41 patients with PPH; of the 40 patients studied, 9 (22.5%) had evidence of hypothyroidism.

Primary pulmonary hypertension and hypothyroidism may share a common autoimmune etiology. Primary pulmonary hypertension is associated with autoimmune antibodies even in the absence of clinical autoimmune disease. Patients with both PPH and hypothyroidism have clinical evidence of connective tissue diseases or positive serological markers of autoimmunity. Yanai-Landau et al³ found a 30% prevalence of antithyroglobulin antibodies in 40 patients with PPH. This prevalence is important as the likelihood of progression of subclinical hypothyroidism to clinical . . . [Full Text of this Article]

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