Effective immunosuppressive therapy in a patient with primary pulmonary hypertension

The case history is described of a young woman who presented with primary p ulmonary hypertension and non-specific inflammatory signs. The patient rece ived prolonged immunosuppressive treatment with low dose methotrexate and p rednisone without any vasodilator agent. After one year the pulmonary arter y pressure fell from a mean value of 47 mm Hg to 30 mm Hg and there was a c orresponding clinical response. This case suggests that, in patients with p ulmonary hypertension of unknown origin, immunopathogenetic factors should be sought in order to consider the utility of immunosuppressive therapy.