CC BY-NC-ND 4.0 · AJP Rep 2019; 09(02): e133-e137
DOI: 10.1055/s-0039-1684026
Case Report
Thieme Medical Publishers 333 Seventh Avenue, New York, NY 10001, USA.

Successful Management of Pulmonary Arterial Hypertension by Monitoring N-Terminal Pro-B-Type Natriuretic Peptide Serum Levels in a Preterm Infant with Chronic Lung Disease: A Case Report

Keigo Seki
1  Department of Pediatrics, Hamamatsu University School of Medicine, Hamamatsu, Japan
,
Satoru Iwashima
1  Department of Pediatrics, Hamamatsu University School of Medicine, Hamamatsu, Japan
,
Hiroki Uchiyama
1  Department of Pediatrics, Hamamatsu University School of Medicine, Hamamatsu, Japan
,
Akira Ohishi
1  Department of Pediatrics, Hamamatsu University School of Medicine, Hamamatsu, Japan
,
Takamichi Ishikawa
1  Department of Pediatrics, Hamamatsu University School of Medicine, Hamamatsu, Japan
› Author Affiliations
Funding Equipment provided by the Hamamatsu University School of Medicine was used. This research received no specific grant from any funding agency in the public, commercial, or not-for-profit sectors. Each author listed on the manuscript has seen and approved the submission of this version of the manuscript and takes full responsibility for the manuscript. If the article is accepted for publication, the disclosure statement may be published. This study has no sponsor. This is a case report. The decision to submit the manuscript for publication was made by Satoru Iwashima. The author who wrote the first draft of the manuscript is Satoru Iwashima. There was no honorarium, grant, or other form of payment made to produce this manuscript.
Further Information

Publication History

05 November 2018

24 February 2019

Publication Date:
09 April 2019 (online)

Abstract

We measured the serial changes in N-terminal probrain natriuretic peptide (NT-proBNP) levels in a 6-month-old male infant with chronic lung disease (CLD) complicated by pulmonary arterial hypertension (PAH). The patient was born at the 24th week of gestation weighing 695 g. At 1 month after birth, an echocardiogram confirmed the diagnosis of CLD with PAH. He was treated with inhaled nitric oxide (iNO) and oral sildenafil and discharged from the hospital. At 190 days of age, the patient was readmitted to our department because of a viral upper respiratory infection. At 195 days of age, his respiratory condition worsened with pulmonary edema and his NT-proBNP level was determined to be 10,117 pg/mL. The patient was immediately administered iNO, and his respiratory condition improved, and NT-proBNP levels decreased. However, he experienced repeated severe cyanosis attacks. Before the attacks, his NT-proBNP level was > 1,000 pg/mL. Therefore, we continuously administered iNO until his NT-proBNP level decreased to < 1,000 pg/mL. We safely discontinued iNO administration at 473 days of age. In conclusion, serial change in NT-proBNP is a surrogate marker with prognostic value in patients with PAH associated with CLD.