Hepatopulmonary Syndrome and Multiple Arteriovenous Fistulas in a Child with Niemann-Pick Disease

Pediatr Allergy Immunol Pulmonol. 2021 Mar;34(1):30-32. doi: 10.1089/ped.2020.1244.

Abstract

Background: Niemann-Pick disease (NPD) is caused by abnormal storage of sphingomyelin. NPD may affect the pulmonary system and cause hypoxia. In the present case, both hepatopulmonary syndrome (HPS) and pulmonary arteriovenous fistulas (PAVFs) developed in a child with NPD and were successfully treated with repeated embolization. Case Presentation: We have reported the case of a 16-year-old-girl with NPD who suffered severe hypoxia, dyspnea, fatigue, had multiple PAVFs, and was diagnosed with type 2 HPS. To improve oxygenation, 10 PAVFs were embolized. She needed re-embolization after 9 months because of hypoxia redevelopment. Conclusions: Pulmonary involvement, HPS, and/or PAVFs could be responsible for hypoxemia in patients with NPD, who should, therefore, be investigated for HPS and PAVFs. Embolization could be beneficial. Some patients may need repeated embolization.

Keywords: Niemann-Pick disease; embolization; hypoxia.

Publication types

  • Case Reports

MeSH terms

  • Adolescent
  • Arteriovenous Fistula / complications*
  • Arteriovenous Fistula / therapy
  • Dyspnea / complications
  • Embolization, Therapeutic / methods*
  • Fatigue / complications
  • Female
  • Hepatopulmonary Syndrome / complications
  • Hepatopulmonary Syndrome / diagnosis*
  • Humans
  • Hypoxia / etiology*
  • Niemann-Pick Diseases / complications*
  • Pulmonary Artery / abnormalities*
  • Pulmonary Veins / abnormalities*
  • Treatment Outcome

Supplementary concepts

  • Pulmonary Arteriovenous Fistulas