title: Treatment of hepatic hydrothorax with terlipressin in a cirrhotic patient.
abstract: Hepatic hydrothorax is a complication of cirrhosis that is uncommon and difficult to treat. Diuretic therapy, thoracentesis, transjugular intrahepatic portosystemic shunt and liver transplantation are the main therapeutic options. Here, we report on a 47-year-old man with decompensated liver cirrhosis related to hepatitis B and D virus infections and who had complications of hepatic hydrothorax and hepatorenal syndrome. In this case, the hepatic hydrothorax, which was refractory to thoracic tube drainage and octreotide treatment, could be controlled with 5 days of terlipressin therapy associated with albumin. Terlipressin administration resulted in both improvement in renal function and successful resolution of hepatic hydrothorax. Splanchnic vasoconstrictor agents that reduce splanchnic blood flow, increase both central volume and effective renal blood flow. Thus they improve renal function. In our case, terlipressin, known to be beneficial in hepatorenal syndrome, was also effective in the treatment of hepatic hydrothorax probably by similar mechanisms. This is the first case in the literature.
authors.affiliation: Department of Internal Medicine, Division of Gastroenterohepatology, Istanbul University, Istanbul Medical Faculty, Capa, TR-34390 Istanbul, Turkey.
authors.forename: Duygu
authors.initials: D
authors.lastname: Ibrisim
authors.forename: Yilmaz
authors.initials: Y
authors.lastname: Cakaloglu
authors.forename: Filiz
authors.initials: F
authors.lastname: Akyuz
authors.forename: Aytac
authors.initials: A
authors.lastname: Karadag
authors.forename: Sadakat
authors.initials: S
authors.lastname: Ozdil
authors.forename: Fatih
authors.initials: F
authors.lastname: Besisik
authors.forename: Zeynel
authors.initials: Z
authors.lastname: Mungan
authors.forename: Atilla
authors.initials: A
authors.lastname: Okten
mesh_terms: D000418:Albumins / Q000627:therapeutic use; D006509:Hepatitis B / Q000150:complications; D003699:Hepatitis D / Q000150:complications; D006801:Humans; D006876:Hydrothorax / Q000188:drug therapy* / Q000209:etiology*; D008103:Liver Cirrhosis / Q000150:complications*; D008236:Lypressin / Q000031:analogs & derivatives* / Q000627:therapeutic use; D008297:Male; D008875:Middle Aged; D000077585:Terlipressin; D014662:Vasoconstrictor Agents / Q000627:therapeutic use*
chemical_list: D000418:Albumins; D014662:Vasoconstrictor Agents; D008236:Lypressin; D000077585:Terlipressin