title: Ancient remedies revisited: does Allium sativum (garlic) palliate the hepatopulmonary syndrome?
abstract: Hypoxia in the setting of liver disease is often multifactorial. Obstructive or restrictive lung disease, pleural effusions, and tense ascites are common underlying disorders. Less often observed and frequently unrecognized is hypoxia related to diffuse intrapulmonary shunting--the hepatopulmonary syndrome. Its etiology is unknown but may result from disordered gut peptide metabolism. Symptoms may be ameliorated by somatostatin and reversed by successful liver transplantation. Here we report a patient with severe hepatopulmonary syndrome who failed somatostatin therapy and declined liver transplantation. On her own the patient took large daily doses of powdered garlic (Allium sativum). She has experienced partial palliation of her symptoms and some objective signs of improvement over 18 months of continuous self-medication. The possible effects of garlic's main physiologically active compound, allicin, on gut peptide metabolism and pulmonary vasculature are unknown. This innocuous compound may deserve further investigation given the limited therapeutic options for this disorder.
authors: University of Miami, Florida.
authors: S H
authors: SH
authors: Caldwell
authors: L J
authors: LJ
authors: Jeffers
authors: O S
authors: OS
authors: Narula
authors: E A
authors: EA
authors: Lang
authors: K R
authors: KR
authors: Reddy
authors: E R
authors: ER
authors: Schiff
mesh_terms: D001164:Arteriovenous Fistula / Q000628:therapy; D002908:Chronic Disease; D004452:Echocardiography; D005260:Female; D005737:Garlic; D006801:Humans; D000860:Hypoxia / Q000175:diagnosis / Q000628:therapy*; D008103:Liver Cirrhosis / Q000188:drug therapy / Q000628:therapy*; D008171:Lung Diseases / Q000000981:diagnostic imaging / Q000628:therapy; D008875:Middle Aged; D015282:Octreotide / Q000627:therapeutic use; D010946:Plants, Medicinal; D011651:Pulmonary Artery / Q000000981:diagnostic imaging; D011667:Pulmonary Veins / Q000000981:diagnostic imaging; D011859:Radiography; D013577:Syndrome
chemical_list: D015282:Octreotide