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| Reversion of severe hepatopulmonary syndrome in a non cirrhotic patient after corticosteroid treatment for granulomatous hepatitis： A case report and review of the literature | |
| 引用本文： | Tzovaras N,Stefos A,Georgiadou SP,Gatselis N,Papadamou G,Rigopoulou E,Ioannou M,Skoularigis I,Dalekos GN. Reversion of severe hepatopulmonary syndrome in a non cirrhotic patient after corticosteroid treatment for granulomatous hepatitis： A case report and review of the literature[J]. World journal of gastroenterology : WJG, 2006, 12(2): 336-339. DOI: 10.3748/wjg.v12.i2.336 |
| 作者姓名： | Tzovaras N Stefos A Georgiadou SP Gatselis N Papadamou G Rigopoulou E Ioannou M Skoularigis I Dalekos GN |
| 作者单位： | Department of Medicine Academic Liver Unit,Medical School,University of Thessaly,41222 Larissa,Greece,Department of Medicine,Academic Liver Unit,Medical School,University of Thessaly,41222 Larissa,Greece,Department of Medicine,Academic Liver Unit,Medical School,University of Thessaly,41222 Larissa,Greece,Department of Medicine,Academic Liver Unit,Medical School,University of Thessaly,41222 Larissa,Greece,Department of Medicine,Academic Liver Unit,Medical School,University of Thessaly,41222 Larissa,Greece,Department of Medicine,Academic Liver Unit,Medical School,University of Thessaly,41222 Larissa,Greece,Department of Pathology,Medical School,University of Thessaly,41222 Larissa,Greece,Division of Cardiology,Medical School,University of Thessaly,41222 Larissa,Greece,Department of Medicine,Academic Liver Unit,Medical School,University of Thessaly,41222 Larissa,Greece |
| 摘 要： | Hepatopulmonary syndrome (HPS) is defined as a clinical triad including liver disease, abnormal pulmonary gas exchange and evidence of intrapulmonary vascular dilatations. We report a 61-year-old male presented with fatigue, long-lasting fever, loss of weight, signs of portal hypertension, hepatosplenomegaly, cholestasis and progressive dyspnoea over the last year. Clinical, laboratory and histological findings confirmed the diagnosis of granulomatous hepatitis. HPS due to hepatic granuloma-induced portal hypertension was proved to be the cause of severe hypoxemia of the patient as confirmed by contrast-enhanced echocardiography. Reversion of HPS after corticosteroid therapy was confirmed by a new contrast-enhanced echocardiography along with the normalization of cholestatic enzymes and improvement of the patient' s conditions. This is the first case of complete reversion of HPS in a non-cirrhotic patient with hepatic granuloma, indicating that intrapulmonary shunt in liver diseases is a functional phenomenon and HPS can be developed even in miscellaneous liver involvement as in this case. |
| 关 键 词： | 肝肾综合征 肉芽肿肝炎 肝硬化 HPS 直立型低氧血症 |
| 收稿时间： | 2005-06-15 |
Reversion of severe hepatopulmonary syndrome in a non cirrhotic patient after corticosteroid treatment for granulomatous hepatitis: a case report and review of the literature |
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| Tzovaras Nikolaos,Stefos Aggelos,Georgiadou Sarah P,Gatselis Nikolaos,Papadamou Georgia,Rigopoulou Eirini,Ioannou Maria,Skoularigis Ioannis,Dalekos Georgios N. Reversion of severe hepatopulmonary syndrome in a non cirrhotic patient after corticosteroid treatment for granulomatous hepatitis: a case report and review of the literature[J]. World journal of gastroenterology : WJG, 2006, 12(2): 336-339. DOI: 10.3748/wjg.v12.i2.336 | |
| Authors: | Tzovaras Nikolaos Stefos Aggelos Georgiadou Sarah P Gatselis Nikolaos Papadamou Georgia Rigopoulou Eirini Ioannou Maria Skoularigis Ioannis Dalekos Georgios N |
| Affiliation: | 1. Department of Medicine, Academic Liver Unit, Medical School, University of Thessaly, 41222 Larissa, Greece 2. Department of Pathology, Medical School, University of Thessaly, 41222 Larissa, Greece 3. Division of Cardiology, Medical School,University of Thessaly, 41222 Larissa, Greece |
| Abstract: | Hepatopulmonary syndrome (HPS) is defined as a clinical triad including liver disease, abnormal pulmonary gas exchange and evidence of intrapulmonary vascular dilatations. We report a 61-year-old male presented with fatigue, long-lasting fever, loss of weight, signs of portal hypertension, hepatosplenomegaly, cholestasis and progressive dyspnoea over the last year. Clinical, laboratory and histological findings confirmed the diagnosis of granulomatous hepatitis. HPS due to hepatic granuloma-induced portal hypertension was proved to be the cause of severe hypoxemia of the patient as confirmed by contrast-enhanced echocardiography. Reversion of HPS after corticosteroid therapy was confirmed by a new contrast-enhanced echocardiography along with the normalization of cholestatic enzymes and improvement of the patient' s conditions. This is the first case of complete reversion of HPS in a non-cirrhotic patient with hepatic granuloma, indicating that intrapulmonary shunt in liver diseases is a functional phenomenon and HPS can be developed even in miscellaneous liver involvement as in this case. |
| Keywords: | Hepatopulmonary syndrome Granulomatous hepatitis Liver cirrhosis Orthodeoxia Platypnoea |
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