Transient hepatopulmonary syndrome in a patient with acute hepatitis A

A. Regev, M. Yeshurun, M. Rodriguez, A. Sagie, G. W. Neff, E. G. Molina, E. R. Schiff

Research output: Contribution to journalArticlepeer-review

66 Scopus citations

Abstract

The hepatopulmonary syndrome is defined as the triad of liver disease, hypoxaemia and intrapulmonary vascular dilatation. This syndrome has been described in patients with liver cirrhosis, noncirrhotic portal hypertension, and fulminant hepatic failure, however, there are no previous descriptions of hepatopulmonary syndrome in patients with acute nonfulminant viral hepatitis. We report a 47-year-old, previously healthy man that presented with acute hepatitis A, and developed progressive dyspnoea, platypnoea and orthodeoxia with no evidence of parenchymal or thromboembolic lung disease. PaO2 on room air was 58 mmHg, O2 saturation was 88% and alveolar-arterial O2 gradient was 62%. During his hospitalization serum albumin level decreased to 3.1 g/dl and prothrombin time was prolonged to 16,8 s, however, he remained alert with no signs of hepatic encephalopathy. Contrast echocardiography revealed left heart chamber opacification 3-4 cardiac cycles after the opacification of the right heart chamber, consistent with hepatopulmonary syndrome. During the following days there was a gradual improvement in the patient's condition, with resolution of his dyspnoea and gradual increase of PaO2. Repeat contrast echocardiography and PaO2 determinations, 3 weeks later, were normal. On long-term followup the patient remained asymptomatic with normal liver function tests and normal O2 saturation. This report indicates that hepatopulmonary syndrome may be a transient manifestation of acute hepatitis A in the absence of fulminant liver failure.

Original languageEnglish (US)
Pages (from-to)83-86
Number of pages4
JournalJournal of viral hepatitis
Volume8
Issue number1
DOIs
StatePublished - Feb 14 2001

Keywords

  • Hepatitis A
  • Hepatopulmonary syndrome
  • Hypoxaemia

ASJC Scopus subject areas

  • Hepatology
  • Virology

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