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Pulmonary arterial hypertension in patient treated for multiple sclerosis with 4‐aminopyridine
Author(s) -
Ribeiro Baptista Bruno,
Petitpain Nadine,
Gomez Emmanuel,
YelehéOkouma Melissa,
Valentin Simon,
Guillaumot Anne,
Chabot François,
Chaouat Ari
Publication year - 2019
Publication title -
fundamental and clinical pharmacology
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 0.655
H-Index - 73
eISSN - 1472-8206
pISSN - 0767-3981
DOI - 10.1111/fcp.12396
Subject(s) - ambrisentan , tadalafil , medicine , pulmonary hypertension , discontinuation , pulmonary artery , 4 aminopyridine , cardiology , etiology , potassium channel blocker , multiple sclerosis , blood pressure , bosentan , erectile dysfunction , potassium channel , receptor , psychiatry , endothelin receptor
4‐Aminopyridine (4‐ AP ) is a recent treatment indicated to improve walking in patient with multiple sclerosis. We report the first case of pulmonary arterial hypertension ( PAH ) that we attribute to the use of 4‐ AP . A 64‐year‐old woman with multiple sclerosis presented with dyspnea. After excluding other secondary causes of pulmonary hypertension, a diagnosis of severe PAH due to 4‐ AP was made based on right heart catheterization. History revealed that the dyspnea began with the initiation of 4‐ AP . After discontinuation of 4‐ AP therapy and initiation of ambrisentan and tadalafil, dyspnea and pulmonary arterial pressure have improved significantly and one specific PAH treatment was stopped. 4‐ AP is an outward rectifying potassium channel blocker with a vasoconstrictor effect in animal's pulmonary artery. According to the chronological sequence of events, the lack of other etiology, and its pharmacological plausibility, 4‐ AP is highly suspected to have induced our patient's PAH .