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Iacoi A, Brobeil A, Götte M, Enzensberger C, Müller V, Gattenlöhner S, Axt-Fliedner R. Hydrops Fetalis and Congenital Pulmonary Capillary Haemangiomatosis in a Premature Infant - A Case Report and Literature Review. PRENATAL CARDIOLOGY 2018. [DOI: 10.1515/pcard-2018-0011] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/15/2022] Open
Abstract
Abstract
Pulmonary capillary haemangiomatosis (PCH) is a rare disorder of the lung, well described in adult literature. PCH is characterized by capillary proliferation, infiltrating the interstitium and alveolar walls. This leads to development of respiratory distress and to end-stage pulmonary hypertension. Mostly young adults are affected. The affection of newborn is described in less than ten cases in literature in the past forty years. PCH is a mostly deadly ending disease. We present a preterm born infant with antepartal diagnosed hydrops fetalis, who died 30 minutes after birth. Autopsy revealed PCH as lethal reason and not cardial disease as presumed before.
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Affiliation(s)
- Anna Iacoi
- Division of Prenatal Medicine, Dept. Ob&Gyn , Justus-Liebig-University , Gießen
| | | | - Malena Götte
- Division of Prenatal Medicine, Dept. Ob&Gyn , Justus-Liebig-University , Gießen
| | | | - Vera Müller
- Division of Prenatal Medicine, Dept. Ob&Gyn , Justus-Liebig-University , Gießen
| | | | - Roland Axt-Fliedner
- Division of Prenatal Medicine, Dept. Ob&Gyn , Justus-Liebig-University , Gießen
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Abstract
We describe the cases of two children who both presented in infancy with recurrent severe pulmonary hypertensive crises. Exhaustive clinical work-up failed to identify an underlying aetiology. The patients had no clinical response to steroids, immunoglobulins, or pulmonary vasodilators. Post-mortem examination revealed extensive invasive pulmonary capillary haemangiomatosis. There was no evidence of pulmonary venous occlusive disease. Given the lethal nature of this condition, early consideration of referral to a lung transplant centre should be considered in selected patients.
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Pulmonary capillary hemangiomatosis in a neonate with congenital diaphragmatic hernia. Pediatr Surg Int 2015; 31:501-4. [PMID: 25678439 DOI: 10.1007/s00383-015-3678-z] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Accepted: 01/27/2015] [Indexed: 10/24/2022]
Abstract
Pulmonary capillary hemangiomatosis (PCH) is a rare cause of pulmonary hypertension (PHTN). We present a neonate with congenital diaphragmatic hernia (CDH) and concurrent PCH. Severe PHTN was unrelenting and death occurred at 4 months. Diagnosis of PCH is challenging in the setting of CDH and portends a poor prognosis.
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Best DH, Sumner KL, Austin ED, Chung WK, Brown LM, Borczuk AC, Rosenzweig EB, Bayrak-Toydemir P, Mao R, Cahill BC, Tazelaar HD, Leslie KO, Hemnes AR, Robbins IM, Elliott CG. EIF2AK4 mutations in pulmonary capillary hemangiomatosis. Chest 2014; 145:231-236. [PMID: 24135949 DOI: 10.1378/chest.13-2366] [Citation(s) in RCA: 135] [Impact Index Per Article: 13.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/01/2022] Open
Abstract
BACKGROUND Pulmonary capillary hemangiomatosis (PCH) is a rare disease of capillary proliferation of unknown cause and with a high mortality. Families with multiple affected individuals with PCH suggest a heritable cause although the genetic etiology remains unknown. METHODS We used exome sequencing to identify a candidate gene for PCH in a family with two affected brothers. We then screened 11 unrelated patients with familial (n = 1) or sporadic (n = 10) PCH for mutations. RESULTS Using exome sequencing, we identified compound mutations in eukaryotic translation initiation factor 2 α kinase 4 (EIF2AK4) (formerly known as GCN2) in both affected brothers. Both parents and an unaffected sister were heterozygous carriers. In addition, we identified two EIF2AK4 mutations in each of two of 10 unrelated individuals with sporadic PCH. EIF2AK4 belongs to a family of kinases that regulate angiogenesis in response to cellular stress. CONCLUSIONS Mutations in EIF2AK4 are likely to cause autosomal-recessive PCH in familial and some nonfamilial cases.
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Affiliation(s)
- D Hunter Best
- Department of Pathology, The University of Utah, Salt Lake City, UT; ARUP Institute for Clinical and Experimental Pathology, ARUP Laboratories, Salt Lake City, UT
| | - Kelli L Sumner
- ARUP Institute for Clinical and Experimental Pathology, ARUP Laboratories, Salt Lake City, UT
| | - Eric D Austin
- Department of Pathology, The University of Utah, Salt Lake City, UT; Department of Pediatrics, Vanderbilt University Medical Center, Nashville, TN
| | - Wendy K Chung
- Departments of Pediatrics and Medicine, Columbia University Medical Center, New York, NY
| | - Lynette M Brown
- Department of Medicine, School of Medicine, and Pulmonary Division, The University of Utah, Salt Lake City, UT; Department of Medicine, Intermountain Medical Center, Intermountain Healthcare, Murray, UT
| | - Alain C Borczuk
- Department of Pathology and Cell Biology, Columbia University Medical Center, New York, NY
| | - Erika B Rosenzweig
- Departments of Pediatrics and Medicine, Columbia University Medical Center, New York, NY
| | - Pinar Bayrak-Toydemir
- ARUP Institute for Clinical and Experimental Pathology, ARUP Laboratories, Salt Lake City, UT
| | - Rong Mao
- ARUP Institute for Clinical and Experimental Pathology, ARUP Laboratories, Salt Lake City, UT
| | - Barbara C Cahill
- Department of Medicine, The University of Utah, Salt Lake City, UT
| | - Henry D Tazelaar
- Department of Laboratory Medicine and Pathology, Mayo Clinic Arizona, Mayo Foundation for Medical Education and Research, Scottsdale, AZ
| | - Kevin O Leslie
- Department of Laboratory Medicine and Pathology, Mayo Clinic Arizona, Mayo Foundation for Medical Education and Research, Scottsdale, AZ
| | - Anna R Hemnes
- Division of Allergy, Pulmonary and Critical Care Medicine, Vanderbilt University Medical Center, Nashville, TN
| | - Ivan M Robbins
- Division of Allergy, Pulmonary and Critical Care Medicine, Vanderbilt University Medical Center, Nashville, TN
| | - C Gregory Elliott
- Department of Medicine, School of Medicine, and Pulmonary Division, The University of Utah, Salt Lake City, UT; Department of Medicine, Intermountain Medical Center, Intermountain Healthcare, Murray, UT.
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Familial pulmonary capillary hemangiomatosis early in life. Case Rep Pulmonol 2011; 2011:827591. [PMID: 22937432 PMCID: PMC3420428 DOI: 10.1155/2011/827591] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/30/2011] [Accepted: 10/03/2011] [Indexed: 11/20/2022] Open
Abstract
Background. Pulmonary capillary hemangiomatosis (PCH) is a rare disease, especially in infancy. Four infants have been reported up to the age of 12 months. So far, no familial patients are observed at this age. Patients. We report three siblings, two female newborns and a foetus of 15-week gestation of unrelated, healthy parents suffering from histologically proven PCH. The first girl presented with increased O2 requirements shortly after birth and patent ductus arteriosus (PDA). She subsequently developed progressive respiratory failure and pulmonary hypertension and died at the age of five months. The second girl presented with clinical signs of bronchial obstruction at the age of three months. The work-up showed a PDA—which was surgically closed—pulmonary hypertension, and bronchial wall instability with stenosis of the left main bronchus. Transient oxygen therapy was required with viral infections. The girl is now six years old and clinically stable without additional O2 requirements. Failure to thrive during infancy and a somewhat delayed development may be the consequence of the disease itself but also could be attributed to repeated episodes of respiratory failure and a long-term systemic steroid therapy. The third pregnancy ended as spontaneous abortion. The foetus showed histological signs of PCH. Conclusion. Despite the differences in clinical course, the trias of PCH, PDA, and pulmonary hypertension in the two life born girls suggests a genetic background.
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Navarini S, Bucher B, Pavlovic M, Pfammatter JP, Casaulta C, Brasch F, Griese M, Regamey N. Pulmonary hypertension presenting with apnea, cyanosis, and failure to thrive in a young child. Chest 2011; 140:1086-1089. [PMID: 21972389 DOI: 10.1378/chest.10-2607] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/01/2022] Open
Affiliation(s)
- Susanne Navarini
- Division of Pediatric Cardiology, Department of Pediatrics, University Children's Hospital of Bern, Bern, Switzerland.
| | - Barbara Bucher
- Division of Pediatric Cardiology, Department of Pediatrics, University Children's Hospital of Bern, Bern, Switzerland
| | - Mladen Pavlovic
- Division of Pediatric Cardiology, Department of Pediatrics, University Children's Hospital of Bern, Bern, Switzerland
| | - Jean-Pierre Pfammatter
- Division of Pediatric Cardiology, Department of Pediatrics, University Children's Hospital of Bern, Bern, Switzerland
| | - Carmen Casaulta
- Division of Pediatric Respiratory Medicine, Department of Pediatrics, University Children's Hospital of Bern, Bern, Switzerland
| | - Frank Brasch
- Institute of Pathology, University of Bochum, Bochum, Germany
| | - Matthias Griese
- Ludwig Maximilians University, Children's Hospital, Munich, Germany
| | - Nicolas Regamey
- Division of Pediatric Respiratory Medicine, Department of Pediatrics, University Children's Hospital of Bern, Bern, Switzerland
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Melegh Z, Patel Y, Ramani P. Solitary pulmonary infantile hemangioma in an infant with atrial septal defect. Pediatr Dev Pathol 2008; 11:465-8. [PMID: 17990917 DOI: 10.2350/07-03-0249.1] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/12/2007] [Accepted: 06/12/2007] [Indexed: 11/20/2022]
Abstract
Pulmonary infantile hemangiomas are extremely rare in infancy and childhood. We describe a case of a 22-month-old infant who presented with repeated chest infections. Imaging studies revealed a solitary parenchymal lung lesion in the left upper lobe, an atrial septal defect, and mild right ventricular dilatation. Various investigations failed to delineate the precise nature of the lung lesion and it was resected. Histological examination of the lung lesion showed an infantile hemangioma, which expressed glucose transporter-1 protein, GLUT-1, a marker of infantile hemangiomas. This case represents a unique coexistence of 2 lesions, both of which resulted in right-sided overload, contributed to mainly by the atrial septal defect causing increased volume and, to a lesser extent, by the pulmonary hemangioma resulting in increased pressure. This case also emphasizes the fact that infantile hemangioma, although rare, should be considered as a differential diagnosis of solitary lung lesions.
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Affiliation(s)
- Zsombor Melegh
- Department of Histopathology, Bristol Royal Infirmary, Marlborough Street, Bristol, BS2 8HW, United Kingdom.
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El-Gabaly M, Farver CF, Budev MA, Mohammed TLH. Pulmonary capillary hemangiomatosis imaging findings and literature update. J Comput Assist Tomogr 2007; 31:608-10. [PMID: 17882042 DOI: 10.1097/01.rct.0000284393.76073.87] [Citation(s) in RCA: 26] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/27/2022]
Abstract
Pulmonary capillary hemangiomatosis (PCH) is a rare and an only recently described vascular disease. As one of the causes of primary pulmonary hypertension, the need for the establishment of helpful diagnostic radiological criteria for this condition has become imperative. However, the unstable hemodynamic condition of patients with primary pulmonary hypertension often denies pathological sampling as a definitive diagnostic tool. This diagnostic dilemma can be fatal to those patients with PCH treated for pulmonary hypertension because a fatal pulmonary edema may occur. We report a case of PCH in a 26-year-old patient who died of severe circulatory compromise while undergoing transplant evaluation. A discussion of the computed tomography findings, a review of the pathological features, and a review of the relatively limited imaging literature available on this subject are conducted.
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Affiliation(s)
- Mohamed El-Gabaly
- Section of Thoracic Imaging, Division of Radiology, Cleveland Clinic Foundation, Cleveland, OH 44195, USA
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Rose AS, Mathur PN. Endobronchial capillary hemangioma: case report and review of the literature. ACTA ACUST UNITED AC 2007; 76:221-4. [PMID: 17268168 DOI: 10.1159/000099008] [Citation(s) in RCA: 22] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/11/2006] [Accepted: 11/29/2006] [Indexed: 01/19/2023]
Abstract
A 66-year-old man with mitral stenosis on coumadin presents with hemoptysis caused by a capillary hemangioma of the proximal airways. Argon plasma coagulation was utilized to treat the lesions resulting in resolution of hemoptysis. Tracheobronchial capillary hemangiomas are rare in adults, but are easily discovered and treated with bronchoscopic intervention. The literature to date is reviewed pertaining to adult tracheobronchial capillary hemangiomas.
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Affiliation(s)
- Anthony S Rose
- Division of Pulmonary and Critical Care, Indiana University Medical Center, Indianapolis, Indiana 46202, USA.
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