alexa Hepatopulomnary Syndrome among Cirrhotic Patients in Up
ISSN: 2167-0889

Journal of Liver
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Research Article

Hepatopulomnary Syndrome among Cirrhotic Patients in Upper Egypt: Prevalence, Clinical Presentations and Laboratory Features

Nahed Ahmed Makhlouf1*, Ali Abdel Azeem2, Hoda Ahmed Makhlouf2, Ehab Abdou Moustafa1 and Mohamed Abdel Ghany3
1Department of Tropical Medicine and Gastroenterology, Faculty of Medicine, Assiut University, Egypt
2Department of Chest Diseases and Tuberculosis, Faculty of Medicine, Assiut University, Egypt
3Department of Cardiology, Faculty of Medicine, Assiut University, Egypt
Corresponding Author : Nahed A Makhlouf
Department of Tropical Medicine and Gastroenterology
Faculty of Medicine
Assiut University Assiut 71111, Egypt
Tel: (+20)100-3611626
Fax: (+20)88-2354130
E-mail: nahedmak@yahoo.com
Received May 10, 2012; Accepted July 15, 2012; Published July 20, 2012
Citation: Makhlouf NA, Azeem AA, Makhlouf HA, Moustafa EA, Ghany MA (2012) Hepatopulomnary Syndrome among Cirrhotic Patients in Upper Egypt: Prevalence, Clinical Presentations and Laboratory Features. J Liver 1:108. doi: 10.4172/2167-0889.1000108
Copyright: © 2012 Makhlouf NA, et al. This is an open-access article distributed under the terms of the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original author and source are credited.
 

Abstract

Background: The prevalence of Hepatopulmonary Syndrome (HPS) ranges from 5 to 32% from livertransplantation centers. Egypt is considered as one of the highest countries in prevalence and incidence of bilharizial peri-portal fibrosis and Hepatitis C Virus (HCV) induced liver cirrhosis. Clinical, radiological and laboratory features of HPS were not widely assessed. Objectives: To determine the prevalence, clinical features and laboratory features of HPS among Egyptian cirrhotic patients. Patients and Methods: Our study included 570 cirrhotic patients. Arterial blood gases analysis, chest X-ray, pulmonary function tests and transthoracic contrast echocardiography for detection of pulmonary vasodilatation were done for patients with partial pressure of arterial O2<80 mmHg. Also, clinical and laboratory features were assessed. Diagnostic criteria of HPS in cirrhotic patients include arterial hypoxemia and pulmonary vascular dilatation on contrast enhanced echocardiography. Results: The prevalence of HPS among patients with liver cirrhosis was 4.2%. Patients with HPS had more severe cirrhosis, as determined by advanced Child-Pugh Grade. The presence of dyspnea, platypnea, clubbing, and orthodoxia was significantly higher in patients with HPS when compared to cirrhotic patients (P value<0 .001). In HPS, right pleural effusion and bilateral basal shadows were the commonest radiological findings (20.8% while chest X- ray of most patients with liver cirrhosis was normal (85%) (P value<0.05). There was a significant decrease in PaO2 and O2 saturation (P<0.001 for each) but a significant increase in P (A-a) O2 in patients with HPS versus cirrhotic patients (P<0.001). Patients with HPS showed a restrictive dysfunction in 59.3%. Conclusion: The prevalence of HPS among cirrhotic patients was 4.2%. The presence of dyspnea, platypnea, clubbing, orthodoxia and arterial hypoxemia were the commonest feature. Right pleural effusion and bilateral basal shadows were the commonest radiological findings.

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