Hepatopulmonary syndrome and portopulmonary hypertension coexisting in a case of wilson's disease cirrhosis: 'Double trouble'

Autor: V V. S. S. Sagar, Sourya Acharya, Gajendra Agrawal, Samarth Shukla, Sunil Kumar, Chitturi Venkata Sai Akhil
Jazyk: angličtina
Rok vydání: 2022
Předmět:
Zdroj: Indian Journal of Respiratory Care, Vol 11, Iss 2, Pp 176-180 (2022)
Druh dokumentu: article
ISSN: 2277-9019
2321-4899
DOI: 10.4103/ijrc.ijrc_150_21
Popis: Wilson's disease is one of the infrequent causes of hepatic failure with a wide clinical spectrum. Hepatic and neuropsychiatric manifestations are the most common, whereas atypical presentations were also reported as the complications of hepatic failure such as hepatopulmonary syndrome (HPS) and portopulmonary hypertension (POPH). These are considered pulmonary complications of hepatic disease with underlying complex pathology and various vasoactive substances such as endothelin 1 and nitric oxide on the pulmonary blood vessels. HPS usually presents with breathlessness and central cyanosis. The triad of HPS comprises dilatation of pulmonary vasculature, intrapulmonary shunting, and hypoxia, whereas POPH causes vasoconstriction and vascular remodeling leading to increased resistance in pulmonary blood vessels and subsequent right ventricular dysfunction. In this case report, we highlight two antagonistic pathological processes coexisting in the same patient.
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