Hormone-replacement Therapy for Hepatopulmonary Syndrome and NASH Associated with Hypopituitarism

Intern Med. 2018;57(12):1741-1745. doi: 10.2169/internalmedicine.0027-17. Epub 2018 Jun 15.

Abstract

The patient was a 23-year-old man who was diagnosed with severe hypoxemia and liver dysfunction after suffering from sudden difficulty breathing. At 2 years of age, he had been diagnosed with hypopituitarism, and had received hormone-replacement until he was 18 years of age. Echocardiography using micro bubbles and pulmonary scintigraphy indicated intrapulmonary shunt and a liver biopsy showed steatohepatitis. He was diagnosed with hepatopulmonary syndrome associated with nonalcoholic steatohepatitis. Hormone-replacement therapy was re-started. After 5 months, a second liver biopsy revealed the amelioration of nonalcoholic steatohepatitis, which improved his respiratory condition. This case suggested that early effective therapy for chronic liver diseases might improve the pathological and clinical conditions of hepatopulmonary syndrome.

Keywords: hepatopulmonary syndrome; hypopituitarism; nonalcoholic steatohepatitis.

Publication types

  • Case Reports

MeSH terms

  • Adrenal Cortex Hormones / therapeutic use
  • Adult
  • Growth Hormone / therapeutic use
  • Hepatopulmonary Syndrome / complications*
  • Hepatopulmonary Syndrome / drug therapy*
  • Hormone Replacement Therapy / methods*
  • Humans
  • Hypopituitarism / drug therapy*
  • Hypopituitarism / etiology*
  • Male
  • Non-alcoholic Fatty Liver Disease / drug therapy*
  • Non-alcoholic Fatty Liver Disease / etiology*
  • Testosterone / therapeutic use
  • Thyroid Hormones / therapeutic use
  • Treatment Outcome
  • Young Adult

Substances

  • Adrenal Cortex Hormones
  • Thyroid Hormones
  • Testosterone
  • Growth Hormone