Mem Inst Oswaldo Cruz, Rio de Janeiro, 112(7) July 2017
Schistosomiasis and hepatopulmonary syndrome: the role of concomitant liver cirrhosis
1Universidade Federal de Pernambuco, Programa de Pós-Graduação em Medicina Tropical, Recife, PE, Brasil
2Universidade Federal de Pernambuco, Departamento de Medicina Clínica, Serviço de Gastroenterologia e Hepatologia, Recife, PE, Brasil
3Universidade Federal de Pernambuco, Departamento de Medicina Clínica, Serviço de Cardiologia e Ecocardiografia, Recife, PE, Brasil
4Fundação Oswaldo Cruz-Fiocruz, Laboratório de Métodos Quantitativos em Saúde, Recife, PE, Brasil
BACKGROUND Hepatopulmonary syndrome (HPS) is defined as an oxygenation defect induced by intrapulmonary vasodilation in patients with liver disease or portal hypertension. It is investigated in patients with liver cirrhosis and less frequently in those with portal hypertension without liver cirrhosis, as may occur in hepatosplenic schistosomiasis (HSS).
OBJECTIVES To investigate the prevalence of HPS in patients with HSS, and to determine whether the occurrence of HPS is influenced by concomitant cirrhosis.
METHODS We evaluated patients with HSS with or without concomitant liver cirrhosis. All patients underwent laboratory testing, ultrasound, endoscopy, contrast echocardiography, and arterial blood gas analysis.
FINDINGS Of the 121 patients with HSS, 64 were also diagnosed with liver cirrhosis. HPS was diagnosed in 42 patients (35%) and was more frequent among patients with concomitant liver cirrhosis than in those without cirrhosis (42% vs. 26%), but the difference was not significant (p = 0.069). HPS was more common in those with spider naevi, Child-Pugh classes B or C and high model for end stage liver disease (MELD) scores (p < 0.05 each).
MAIN CONCLUSIONS The prevalence of HPS was 35% in this study. The occurrence of liver cirrhosis concomitantly with HSS may have influenced the frequency of patients presenting with HPS.