Hepatopulmonary syndrome, an unusual cause of hypoxemia.
A six-year-old boy presented with cough, cyanosis and clubbing. Investigations revealed hypoxia (PaO2 53 mm Hg on room air) which was only partially correctable (PaO2 73 mm Hg) with 100% oxygen administered through a non re breathing face mask. Liver function tests showed elevated total bilirubin, and transaminases, liver biopsy confirmed chronic hepatitis and endoscopy showed grade three varices. A contrast enhanced echocardiography (bubble study) revealed pulmonary arterio-venous communication. A diagnosis of hepatopulmonary syndrome was made based on the triad of hypoxemia, liver disease and intra pulmonary vascular communications.
Sindhu
S
S
Department of Pediatrics, All India Institute of Medical Sciences, Ansari Nagar, New Delhi, India.
Ramesh
P
P
Juneja
R
R
Kabra
S K
SK
D002648:Child; D003131:Combined Modality Therapy; D005500:Follow-Up Studies; D020065:Hepatopulmonary Syndrome / Q000150:complications* / Q000175:diagnosis* / Q000628:therapy; D006801:Humans; D000860:Hypoxia / Q000175:diagnosis / Q000209:etiology* / Q000628:therapy; D008297:Male; D018570:Risk Assessment; D012720:Severity of Illness Index