Volume 150, Issue 3, Pages 748-749 (September 2016) Familial Chronic Thromboembolic Pulmonary Hypertension in a Pair of Japanese Brothers  Masaharu Kataoka, MD, PhD, Yuichi Momose, MD, Yuki Aimi, MHS, Keiichi Fukuda, MD, PhD, Shinobu Gamou, PhD, Toru Satoh, MD, PhD  CHEST  Volume 150, Issue 3, Pages 748-749 (September 2016) DOI: 10.1016/j.chest.2016.06.021 Copyright © 2016 American College of Chest Physicians Terms and Conditions

Figure 1 Patients’ family tree. Red squares represent the two individuals (brothers) with chronic thromboembolic pulmonary hypertension (CTEPH) in this family. Their thrombophilia was excluded by testing of parotein C, protein S, lupus anticoagulant, anticardiolipin antibody, anticardiolipin β2-glycoprotein I antibody, and antithrombin III. Although the younger brother (case 2) had experienced DVT and acute pulmonary embolism before the diagnosis of CTEPH, neither of the brothers had any of the other known risk factors for CTEPH (eg, splenectomy). Their father died of pancreatic cancer, and one of their maternal uncles died of stomach cancer. Furthermore, in family members other than these two brothers, there were no cases with a evident history of CTEPH, no deaths suspicious for CTEPH, no members who had suspicious but unproven CTEPH (eg, right-sided heart failure in a patient with a history of pulmonary embolism), no members who had DVT and/or pulmonary embolism, and no members with postphlebitic syndrome. CHEST 2016 150, 748-749DOI: (10.1016/j.chest.2016.06.021) Copyright © 2016 American College of Chest Physicians Terms and Conditions