Pulmonary Hypertension that Developed During Treatment for Hepatopulmonary Syndrome and Pulmonary Arteriovenous Malformation

Yumiko Ikubo; Hajime Kasai; Toshihiko Sugiura; Takahiko Saito; Hiroki Shoji; Seiichiro Sakao; Yasunori Kasahara; Nobuhiro Tanabe; Koichiro Tatsumi

doi:10.2169/internalmedicine.1993-18

CASE REPORTS

Pulmonary Hypertension that Developed During Treatment for Hepatopulmonary Syndrome and Pulmonary Arteriovenous Malformation

Yumiko Ikubo, Hajime Kasai, Toshihiko Sugiura, Takahiko Saito, Hiroki Shoji, Seiichiro Sakao, Yasunori Kasahara, Nobuhiro Tanabe, Koichiro Tatsumi

Author information

Yumiko Ikubo
Department of Respirology, Graduate School of Medicine, Chiba University, Japan
Hajime Kasai
Department of Respirology, Graduate School of Medicine, Chiba University, Japan
Toshihiko Sugiura
Department of Respirology, Graduate School of Medicine, Chiba University, Japan
Takahiko Saito
Department of Medicine, School of Medicine, Chiba University, Japan
Hiroki Shoji
Department of Respirology, Graduate School of Medicine, Chiba University, Japan
Seiichiro Sakao
Department of Respirology, Graduate School of Medicine, Chiba University, Japan
Yasunori Kasahara
Department of Respirology, Graduate School of Medicine, Chiba University, Japan
Department of Respiratory Medicine, Eastern Chiba Medical Center, Japan
Nobuhiro Tanabe
Department of Respirology, Graduate School of Medicine, Chiba University, Japan
Koichiro Tatsumi
Department of Respirology, Graduate School of Medicine, Chiba University, Japan

Keywords: pulmonary hypertension, hepatopulmonary syndrome, pulmonary arteriovenous malformation, liver transplantation

JOURNAL OPEN ACCESS

2019 Volume 58 Issue 12 Pages 1765-1769

DOI https://doi.org/10.2169/internalmedicine.1993-18

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Abstract

Hepatopulmonary syndrome (HPS) and pulmonary arteriovenous malformation (PAVM) are hypoxemic diseases caused by right-to-left shunting but are rarely concomitant with pulmonary hypertension (PH). A 66-year-old woman with chronic hepatitis C was scheduled to undergo liver transplantation. She was referred to our department for hypoxia and an abnormal shadow in the right lung found on a preoperative examination. She was diagnosed with HPS and a PAVM in the right middle lobe. After liver transplantation, PH temporarily developed, but the pulmonary arterial pressure normalized after coil embolization. Combined HPS and PAVM may cause unique changes in pulmonary hemodynamics during treatment.

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