Hepatopulmonary syndrome in liver cirrhosis: report of a case

A 52-year-old woman suffered from exertional dyspnea, 5 years after she was diagnosed with cirrhosis of the liver. Hypoxemia was suspected because of persistent exertional dyspnea and was confirmed by contiguous arterial blood gas tests. After excluding other cardiopulmonary factors, a series of studies including lung perfusion scan, echocardiography and cardiopulmonary cineangiography revealed the cause of hypoxemia to be the patient's liver disease. Hepatopulmonary syndrome was diagnosed. Despite supplemental oxygen therapy and oral garlic powder for 6 months, the patient still had exertional dyspnea and platypnea, and arterial blood gas results did not improve. We report this case to call attention to arterial oxygen desaturation in cases of cirrhosis of the liver, and to emphasize that deteriorating oxygenation in patients with chronic liver disease may be an indication for liver transplantation, as such functional microvascular abnormalities could be reversed by liver transplantation.