Hepatopulmonary syndrome in a woman with hepatic cyrrhosis
https://doi.org/10.18093/0869-0189-2019-29-4-493-498
Abstract
Hepatopulmonary syndrome (HPS) in a severe complication of advanced hepatic diseases. IHPS comprises the following triad of signs: 1) hepatic disease, 2) pulmonary vessels dilation, 3) hypoxemia without cardiorespiratory diseases. Clinical manifestations of HPS are cyanosis, finger clubbing, and platypnoea under the hepatic cyrrhosis. A clinical case of HPS in young woman with hepatic cyrrhosis is described in this article. HPS was resolved after the orthotopic liver transplantation.
About the Authors
A. G. ChuchalinRussian Federation
Aleksandr G. Chuchalin, Doctor of Medicine, Professor, Academician of Russian Academy of Sciences, Head of Department of Hospital Internal Medicine. Pediatric Faculty, N.I.Pirogov Federal Russian National Research Medical University, Healthcare Ministry of Russia; Chairman of the Executive Board of Russian Respiratory Society
ul. Ostrovityanova 1, Moscow, 117997
N. G. Mirtskhulava
Russian Federation
Nona G. Mirtskhulava, Candidate of Medicine, pulmonologist, Head of Pulmonology Department
ul. Krasnykh Partizan 6/2, Krasnodar, 350012
D. V. Dremov
Russian Federation
Denis V. Dremov, pulmonologist, Pulmonology Department
ul. Krasnykh Partizan 6/2, Krasnodar, 350012
Yu. S. Panasenkova
Russian Federation
Yuliya S. Panasenkova, Candidate of Medicine, Pulmonology Department
ul. Krasnykh Partizan 6/2, Krasnodar, 350012
References
1. Кrowka M.J. Hepatopulmonary syndromes. Gut. 2000; 46 (1): 1–4. DOI: 10.1136/gut.46.1.1.
2. EASL Clinical Practice Guidelines: Liver transplantation. J. Hepatol. 2016; 64 (2): 433–485. DOI: 10.1016/j.jhep.2015.10.006.
3. Schenk P., Schöniger-Hekele M., Fuhrmann V. et al. Prognostic significance of the hepatopulmonary syndrome in patients with cirrhosis. Gastroenterology. 2003; 125 (4): 1042–1052. DOI: 10.1016/s0016-5085(03)01207-1.
4. Seward J.B., Hayes D.L., Smith H.C. at al. Platypnea-orthodeoxia: clinical profile diagnostic workup, management and report of seven cases. Mayo Clin. Proc. 1984; 59 (4): 221–231. DOI: 10.1016/s0025-6196(12)61253-1.
5. Robin E.D., Laman D., Horn B.R., Theodore J. Platipnea related to orthodeoxia caused by true vascular lung shunts. N. Engl. J. Med. 1976; 294 (17): 941–943. DOI: 10.1056/NEJM197604222941711.
6. Bruix J., Bosch J., Kravetz D. et al. Effects of prostaglandin inhibition on systemic and hepatic hemodynamic in patients with cirrhosis of the liver. Gastroenterology. 1985; 88 (2): 430–435. DOI: 10.1016/0016-5085(85)90503-7.
7. Cremona G., Higenbottam T.W., Mayoral V. et al. Elevated exhaled nitric oxide in patients with hepatopulmonary syndrome. Eur. Respir. J. 1995; 8 (11): 1883–1885. DOI: 10.1183/09031936.95.08111883.
8. Gotway M., Dotson R., Dawn S. et al. Hypoxemia in a patient with end-stage liver disease. Clin. Pulm. Med. 2005; 12 (1): 61–66. DOI: 10.1097/01.cpm.0000151446.75296.3e.
9. Davis H.H., Schwart D.J., Lefrak S.S. et al. Alveolar-capillary oxygen disecuilibrium in hepatic cirrhosis. Chest. 1978; 73 (4): 507–511. DOI: 10.1378/chest.73.4.507.
10. Кrowka M.J., Cortese D.A. Severe hypoxemia associated with liver disease: Mayo Clinic experience and the experimental use almitrine bimesylate. Mayo Clin. Proc. 1987; 62 (3): 164–173. DOI: 10.1016/s0025-6196(12)62438-0.
11. Offer J., Green L., Houghton A.R., Campbell J. A case of hepatopulmonary syndrome. Echo. Res. Pract. 2015; 2 (2): K25–27. DOI: 10.1530/ERP-14-0100.
12. Kamath P.S. Portopulmonary hypertension and hepatopulmonary syndrome. J. Gastroenterol. Hepatol. 2002; 17 (Suppl. 3): S253–255. DOI: 10.1046/j.1440-1746.17.s3.9.x.
13. Abrams G.A., Nanda N.C., Dubovsky E.V. et al. Use of macroaggregated albumin lung perfusion scan to diagnose hepatopulmonary syndrome: a new approach. Gastroenterology. 1998; 114 (2): 305–310. DOI: 10.1016/S0016-5085(98)70481-0.
14. Rodrigues-Roisin R., Krowka M.J.? Hervé P. et al. Pulmonary-Hepatic vascular Disorders (PHD). Eur. Respir. J. 2004; 24 (5): 861–880. DOI: 10.1183/09031936.04.00010904.
15. Avdeev S.N. [Hepatopulmonary syndrome]. Consilium Medicum. 2016; 18 (3): 30–35.DOI: 10.26442/2075-1753_2016.3.30-35 (in Russian).
16. [Liver Transplantation. National Guidelines]. Moscow: Obshcherossiyskaya obshchestvennaya organizatsiya transplantologov «Rossiyskoe transplantologicheskoe obshchestvo»; 2013. Available at http://transpl.ru/images/cms/data/pdf/nacional_nye_klinicheskie_rekomendacii_po_transplantacii_pecheni.pdf (in Russian).
17. Ivashkin V.T., Morozova M.A., Maevskaya M.V. [Hepatopulmonary syndrome]. Transplantologiya. 2009; (2): 5–8 (in Russian).
Review
For citations:
Chuchalin A.G., Mirtskhulava N.G., Dremov D.V., Panasenkova Yu.S. Hepatopulmonary syndrome in a woman with hepatic cyrrhosis. PULMONOLOGIYA. 2019;29(4):493-498. (In Russ.) https://doi.org/10.18093/0869-0189-2019-29-4-493-498