title: Spontaneous improvement in a patient with the hepatopulmonary syndrome assessed by serial exercise tests.
abstract: A 37 year old patient with chronic active hepatitis progressing to cirrhosis presented with increasing breathlessness and was found to be hypoxic with finger clubbing. A progressive exercise study with measurement of oxygen saturation (SaO2) showed abnormally high ventilation and desaturation to 81% at 100 W. Serial studies over nearly two years showed, first, deterioration, then improvement with lower ventilation and higher saturation levels at all work loads. This could not be correlated with any change in treatment with azathioprine, prednisolone, or propranolol.
authors.affiliation: Department of Medicine, St George's Hospital and Medical School, London.
authors.forename: K B
authors.initials: KB
authors.lastname: Saunders
authors.forename: S S
authors.initials: SS
authors.lastname: Fernando
authors.forename: H R
authors.initials: HR
authors.lastname: Dalton
authors.forename: A
authors.initials: A
authors.lastname: Joseph
mesh_terms: D000328:Adult; D001379:Azathioprine / Q000627:therapeutic use; D005080:Exercise Test / Q000379:methods; D006521:Hepatitis, Chronic / Q000503:physiopathology*; D006801:Humans; D000860:Hypoxia / Q000188:drug therapy / Q000503:physiopathology*; D008103:Liver Cirrhosis / Q000188:drug therapy / Q000503:physiopathology*; D008171:Lung Diseases / Q000188:drug therapy / Q000503:physiopathology*; D008297:Male; D011239:Prednisolone / Q000627:therapeutic use; D011433:Propranolol / Q000627:therapeutic use; D012075:Remission, Spontaneous; D013577:Syndrome
chemical_list: D011239:Prednisolone; D011433:Propranolol; D001379:Azathioprine