{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,5,4]],"date-time":"2026-05-04T20:23:31Z","timestamp":1777926211254,"version":"3.51.4"},"reference-count":7,"publisher":"Oxford University Press (OUP)","issue":"2","license":[{"start":{"date-parts":[[2022,3,11]],"date-time":"2022-03-11T00:00:00Z","timestamp":1646956800000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by-nc\/4.0\/"}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":[],"published-print":{"date-parts":[[2022,6,24]]},"abstract":"<jats:title>ABSTRACT<\/jats:title>\n               <jats:p>We present the case of a 54-year-old woman with a long history of pulmonary hypertension associated with mixed connective tissue disease. She was being treated with pulmonary vasodilators, including epoprostenol and bosetan, but her mean pulmonary arterial pressure (mPAP) gradually worsened. Although her mPAP began to improve with adding sildenafil, ascites occurred. Discontinuing newly initiated drugs and starting diuretics improved her ascites. This suggested that an intensification of the treatment with vasodilators might have led to ascites (on a background of a probable arteriovenous shunt formation) in this patient with a long history of pulmonary hypertension.<\/jats:p>","DOI":"10.1093\/mrcr\/rxac019","type":"journal-article","created":{"date-parts":[[2022,3,11]],"date-time":"2022-03-11T13:20:30Z","timestamp":1647004830000},"page":"203-208","source":"Crossref","is-referenced-by-count":2,"title":["A case of mixed connective tissue disease complicated by pulmonary hypertension and ascites after addition of pulmonary vasodilators"],"prefix":"10.1093","volume":"6","author":[{"given":"Katsuhide","family":"Kusaka","sequence":"first","affiliation":[{"name":"The First Department of Internal Medicine, School of Medicine, University of Occupational and Environmental Health , Kitakyushu, Japan"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Kazuhisa","family":"Nakano","sequence":"additional","affiliation":[{"name":"The First Department of Internal Medicine, School of Medicine, University of Occupational and Environmental Health , Kitakyushu, Japan"},{"name":"Department of Rheumatology, Kawasaki Medical School , Kurashiki, Japan"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Shunsuke","family":"Fukuyo","sequence":"additional","affiliation":[{"name":"The First Department of Internal Medicine, School of Medicine, University of Occupational and Environmental Health , Kitakyushu, Japan"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Yusuke","family":"Miyazaki","sequence":"additional","affiliation":[{"name":"The First Department of Internal Medicine, School of Medicine, University of Occupational and Environmental Health , Kitakyushu, Japan"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Satsuki","family":"Matsunaga","sequence":"additional","affiliation":[{"name":"The First Department of Internal Medicine, School of Medicine, University of Occupational and Environmental Health , Kitakyushu, Japan"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Yoshiya","family":"Tanaka","sequence":"additional","affiliation":[{"name":"The First Department of Internal Medicine, School of Medicine, University of Occupational and Environmental Health , Kitakyushu, Japan"}],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"286","published-online":{"date-parts":[[2022,3,11]]},"reference":[{"key":"2022062410415974100_R1","doi-asserted-by":"crossref","first-page":"29","DOI":"10.1080\/14397595.2019.1709944","article-title":"2019 Diagnostic criteria for mixed connective tissue disease (MCTD): from the Japan research committee of the Ministry of Health, Labor, and Welfare for systemic autoimmune diseases","volume":"31","author":"Tanaka","year":"2021","journal-title":"Mod Rheumatol"},{"key":"2022062410415974100_R2","doi-asserted-by":"crossref","first-page":"893","DOI":"10.1016\/j.humpath.2006.11.022","article-title":"Fibrous remodeling of the pulmonary venous system in pulmonary arterial hypertension associated with connective tissue diseases","volume":"38","author":"Dorfm\u00fcller","year":"2007","journal-title":"Hum Pathol"},{"key":"2022062410415974100_R3","doi-asserted-by":"crossref","first-page":"6","DOI":"10.1024\/0301-1526\/a000065","article-title":"Systemic sclerosis\u2014a systematic overview: part 1\u2014disease characteristics and classification, pathophysiologic concepts, and recommendations for diagnosis and surveillance","volume":"40","author":"Klein-Weigel","year":"2011","journal-title":"Vasa"},{"key":"2022062410415974100_R4","doi-asserted-by":"crossref","first-page":"371","DOI":"10.1183\/09031936.00106008","article-title":"Pulmonary arterial hypertension in 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