Hepatopulmonary syndrome associated with autoimmune liver cirrhosis.
A 46-year-old woman presented for evaluation of liver dysfunction and dyspnoea. Laboratory examination showed high levels of gamma-globulin, immunoglobulin (Ig)G, and antinuclear antibodies. Laparoscopy demonstrated hepatic cirrhosis. Despite normal spirometry, hypoxaemia (which was worse in standing position) and a low diffusing capacity were present. The shunt ratio calculated using arterial blood gas was 6.4%, but was 40% when measured using 99mTc-macroaggregated albumin scanning. The discrepancy between the ratios indicated that hypoxaemia was caused by intrapulmonary vascular dilatation. The patient was diagnosed with hepatopulmonary syndrome associated with autoimmune liver cirrhosis.
Takada
N
N
Allied Health Sciences, School of Medicine, Kitasato University, Kanagawa, Japan. nyyt@ka2.so-net.ne.jp
Abe
T
T
Takahashi
Y
Y
Shibuya
A
A
Tomita
T
T
D005260:Female; D019693:Hepatitis, Autoimmune / Q000150:complications / Q000209:etiology*; D020065:Hepatopulmonary Syndrome / Q000150:complications*; D006801:Humans; D008103:Liver Cirrhosis / Q000150:complications / Q000209:etiology*; D008875:Middle Aged