The Korean Journal of Medicine

The Korean Association of Internal Medicine (대한내과학회)
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Pulmonary Hypertension Associated with Acute Hypoxic Pulmonary Vasoconstriction in a Patient with Acute Myeloid Leukemia

급성 백혈병 환자에서 급성 저산소성 폐혈관수축에 의한 폐고혈압증 1예

  • Song, Mi-Ae (Division of Cardiology, Department of Internal Medicine, The Catholic University of Korea College of Medicine) ;
  • Jung, Min-Young (Division of Cardiology, Department of Internal Medicine, The Catholic University of Korea College of Medicine) ;
  • Kim, Ju-Youn (Division of Cardiology, Department of Internal Medicine, The Catholic University of Korea College of Medicine) ;
  • Kim, Sang-Bae (Division of Cardiology, Department of Internal Medicine, The Catholic University of Korea College of Medicine) ;
  • Lee, Myung-Hyun (Division of Cardiology, Department of Internal Medicine, The Catholic University of Korea College of Medicine) ;
  • Kim, Eun-Hye (Division of Cardiology, Department of Internal Medicine, The Catholic University of Korea College of Medicine) ;
  • Chung, Woo-Baek (Division of Cardiology, Department of Internal Medicine, The Catholic University of Korea College of Medicine)
  • 송미애 (가톨릭대학교 의과대학 내과학교실 순환기내과) ;
  • 정민영 (가톨릭대학교 의과대학 내과학교실 순환기내과) ;
  • 김주연 (가톨릭대학교 의과대학 내과학교실 순환기내과) ;
  • 김상배 (가톨릭대학교 의과대학 내과학교실 순환기내과) ;
  • 이명현 (가톨릭대학교 의과대학 내과학교실 순환기내과) ;
  • 김은혜 (가톨릭대학교 의과대학 내과학교실 순환기내과) ;
  • 정우백 (가톨릭대학교 의과대학 내과학교실 순환기내과)
  • Published : 2012.04.01
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Abstract

Hypoxic pulmonary vasoconstriction is a unique response of the pulmonary circulation to hypoxia. It constitutes part of the self-regulatory mechanism by which pulmonary capillary blood flow is adjusted to alveolar ventilation for maintaining the optimal balance of ventilation and perfusion. In pathological conditions, hypoxic pulmonary vasoconstriction may occur as an acute episode or as a sustained response with pulmonary hypertension and vascular remodeling. We report a case of reversible pulmonary hypertension induced by acute hypoxic pulmonary vasoconstriction in an 18-year-old man with relapsed acute myeloid leukemia, complicated with severe anemia and pneumonia.

저산소성 폐혈관수축은 폐내 환기와 혈액 관류량의 평형을 적절히 유지하기 위한 생리학적 반응이다. 저산소성 폐혈관수축은 폐포 내 저산소증 시 수초 내에 시작되고, 정상 산소 분압상태가 되면 정상화 된다. 그러나 저산소증 상태가 지속되면 작은 폐동맥 수축이 지속되어 폐고혈압이 발생할 수 있으며, 장기적으로는 혈관 재형성을 유발하게 된다. 본 증례에서 저자들은 호흡곤란을 주소로 내원한 급성 골수성 백혈병 환자가 기저 폐질환이 없는 상태에서 폐렴과 빈혈에 의해 발생한 일시적인 급성 저산소증으로 인해 가역적인 저산소성 폐혈관수축이 발생하여 폐고혈압과 우심실 부전이 발생하였다가 2주 만에 급격히 호전된 1예를 경험하였기에 문헌고찰과 함께 보고하는 바이다.

Keywords

References

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