Síndroma hepatopulmonar: Relato de um caso clínico e revisão do tema
Hepatopulmonary syndrome: Case report and literature review
Michele De Santis1, , Luis Vaz Rodrigues1, Fernando Matos2, Fernando Barata3
1 Interno de Pneumologia Centro Hospitalar de Coimbra, EPE
2 Assistente Graduado em Pneumologia Centro Hospitalar de Coimbra, EPE
3 Serviço de Pneumologia, Centro Hospitalar de Coimbra, Quinta dos Vales São Martinho do Bispo, 3046-853 Coimbra
Received 21 August 2009, Accepted 11 December 2009
Resumo

A síndroma hepatopulmonar é uma complicação importante da doença hepática crónica, ocorrendo em 16–24% dos doentes. É caracterizada por aumento do gradiente alveolocapilar com ou sem hipoxemia resultante de vasodilatação intrapulmonar. O curso da doença é progressivo e associado a aumento da morbilidade e mortalidade. Não existe tratamento médico eficaz, sendo o transplante hepático a opção terapêutica prioritária. Como exemplo desta patologia, os autores apresentam o caso clínico de um doente, sexo masculino, 39 anos, enviado à consulta de Pneumologia com informatração de policitemia secundária e dispneia progressiva para esforços de média intensidade e cuja investigação permitiu identificar uma síndroma hepatopulmonar.

Abstract

Hepatopulmonary syndrome is an important complication of chronic liver disease occurring in 16 24% of patients. It is characterized by an increase in alveolar-capillary gradient, with or without hypoxemia, due to intrapulmonary vasodilatation. The course of the disease is progressive and associated with increased morbidity and mortality. There is no effective medical treatment and liver transplant is a priority. To exemplify the authors present the case of a 39 year-old male patient sent to the Pulmonology outpatient clinic and presenting with secondary polycythemia and progressive exertional dyspnoea. Clinical investigation identified a hepatopulmonary syndrome.

Palavras-chaves
Síndroma hepatopulmonar, hipoxemia, hepatopatia, transplante hepático
Key-words
Hepatopulmonary syndrome, hypoxemia, hepatophaty, hepatic transplant
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