Treatment of hepatic hydrothorax with terlipressin in a cirrhotic patient.
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.
Ibrisim
Duygu
D
Department of Internal Medicine, Division of Gastroenterohepatology, Istanbul University, Istanbul Medical Faculty, Capa, TR-34390 Istanbul, Turkey.
Cakaloglu
Yilmaz
Y
Akyuz
Filiz
F
Karadag
Aytac
A
Ozdil
Sadakat
S
Besisik
Fatih
F
Mungan
Zeynel
Z
Okten
Atilla
A
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*
D000418:Albumins; D014662:Vasoconstrictor Agents; D008236:Lypressin; D000077585:Terlipressin