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Pulmonary veno-occlusive disease

Pulmonary vaso-occlusive disease

 

Pulmonary veno-occlusive disease (PVOD) is a very rare disease. It leads to high blood pressure in the lung arteries (pulmonary hypertension).

Causes

 

In most cases, the cause of PVOD is unknown. The high blood pressure occurs in the pulmonary arteries. These lung arteries are directly connected to the right side of the heart.

The condition may be related to a viral infection. It may occur as a complication of certain diseases such as lupus, chemotherapy, or bone marrow transplantation.

The disorder is most common among children and young adults. As the disease gets worse, it causes:

  • Narrowed pulmonary veins
  • Pulmonary artery hypertension
  • Congestion and swelling of the lungs

 

Symptoms

 

Symptoms may include any of the following:

  • Shortness of breath
  • Fatigue on exertion
  • Fainting
  • Coughing up blood
  • Difficulty breathing while lying flat

 

Exams and Tests

 

The health care provider will examine you and ask about your medical history and symptoms.

The exam may reveal:

  • Increased pressure in the neck veins
  • Clubbing of the fingers
  • Bluish coloration of the skin due to lack of oxygen (cyanosis)
  • Swelling in the legs

Your provider may hear abnormal heart sounds when listening to the chest and lungs with a stethoscope.

The following tests may be done:

  • Arterial blood gases
  • Blood oximetry
  • Chest x-ray
  • Chest CT
  • Cardiac catheterization
  • Lung function tests
  • Echocardiogram
  • Lung biopsy

 

Treatment

 

There is currently no known effective medical treatment. However, the following medicines may be helpful for some people:

  • Medicines that widen the blood vessels (vasodilators)
  • Medicines that control the immune system response (such as azathioprine or steroids)

A lung transplant may be needed.

 

Outlook (Prognosis)

 

The outcome is often very poor in infants, with a survival rate of just a few weeks. Survival in adults may be months to a few years.

 

Possible Complications

 

Complications of PVOD may include:

  • Difficulty breathing that gets worse, including at night (sleep apnea)
  • Pulmonary hypertension
  • Right-sided heart failure (cor pulmonale)

 

When to Contact a Medical Professional

 

Call your provider if you have symptoms of this disorder.

 

 

References

Chin K, Channick RN. Pulmonary hypertension. In: Broaddus VC, Mason RJ, Ernst JD, et al, eds. Murray and Nadel's Textbook of Respiratory Medicine. 6th ed. Philadelphia, PA: Elsevier Saunders; 2016:chap 58.

Huertas A, Girerd B, Dorfmuller P, O'Callaghan D, Humbert M, Montani D. Pulmonary veno-occlusive disease: advances in clinical management and treatments. Expert Rev Respir Med. 2011;5(2):217-229. PMID: 21510732. www.ncbi.nlm.nih.gov/pubmed/21510732.

 
  • Respiratory system

    Respiratory system - illustration

    Air is breathed in through the nasal passageways, travels through the trachea and bronchi to the lungs.

    Respiratory system

    illustration

    • Respiratory system

      Respiratory system - illustration

      Air is breathed in through the nasal passageways, travels through the trachea and bronchi to the lungs.

      Respiratory system

      illustration

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        Tests for Pulmonary veno-occlusive disease

         

           

          Review Date: 5/20/2016

          Reviewed By: Todd Gersten, MD, Hematology/Oncology, Florida Cancer Specialists & Research Institute, Wellington, FL. Review provided by VeriMed Healthcare Network. Also reviewed by David Zieve, MD, MHA, Isla Ogilvie, PhD, and the A.D.A.M. Editorial team.

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