Schistosomiasis and hepatopulmonary syndrome: the role of concomitant liver cirrhosis

Abstract

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.

Prediction of minimal hepatic encephalopathy by using an radiomics nomogram in chronic hepatic schistosomiasis patients

“…However, no or mild biochemical evidences of liver dysfunction are showed in compensatory stage CHS patients [ 19 , 20 ]. MHE causing by CHS remains neglected until the patients develop into OHE, upper gastrointestinal bleeding, hepatorenal syndrome or hepatopulmonary syndrome in the late stage of CHS [ 21 , 22 ].…”

Respiratory morbidity in Schistosoma mansoni infection: a rapid review of literature

“…5,7,9 Additionally, more than a third (34%) of patients with hepatosplenic schistosomiasis have been reported to have a hepatopulmonary syndrome caused by pulmonary vasodilation and is characterized by dyspnea, platypnea, peripheral cyanosis and digital clubbing. 6 Characterizing the burden of respiratory symptoms and lung function abnormalities will increase awareness among care providers to attend to respiratory morbidity in acute and chronic schistosomiasis. The main objective of this review is to characterize the burden of respiratory symptoms and lung function abnormalities among patients with S. mansoni.…”

“… 4 , 5 Lung imaging studies report interstitial infiltrates, ill-defined nodular and ground glass opacification and/or consolidative changes which endure beyond the acute phase of the infection. 5 In chronic schistosomiasis, small clinical reports highlight a reduction in the forced vital capacity (FVC) 6 and forced expiratory volume in 1 s (FEV1), 7 and a decrease in exercise tolerance. 8 Further, specific complications of S. mansoni present with respiratory symptoms that have not been well characterized in literature.…”

“… 5 , 7 , 9 Additionally, more than a third (34%) of patients with hepatosplenic schistosomiasis have been reported to have a hepatopulmonary syndrome caused by pulmonary vasodilation and is characterized by dyspnea, platypnea, peripheral cyanosis and digital clubbing. 6 …”