Successful Treatment of Ascites using a Denver® Peritoneovenous Shunt in a Patient with Paroxysmal Nocturnal Hemoglobinuria and Budd-Chiari syndrome

Tomomi Kogiso; Etsuko Hashimoto; Taito Ito; Toshifumi Hara; Yuichi Ikarashi; Kazuhisa Kodama; Makiko Taniai; Nobuyuki Torii; Kentaro Yoshinaga; Satoru Morita; Yutaka Takahashi; Junji Tanaka; Shuji Sakai; Masakazu Yamamoto; Katsutoshi Tokushige

doi:10.2169/internalmedicine.55.7087

CASE REPORTS

Successful Treatment of Ascites using a Denver^® Peritoneovenous Shunt in a Patient with Paroxysmal Nocturnal Hemoglobinuria and Budd-Chiari syndrome

Tomomi Kogiso, Etsuko Hashimoto, Taito Ito, Toshifumi Hara, Yuichi Ikarashi, Kazuhisa Kodama, Makiko Taniai, Nobuyuki Torii, Kentaro Yoshinaga, Satoru Morita, Yutaka Takahashi, Junji Tanaka, Shuji Sakai, Masakazu Yamamoto, Katsutoshi Tokushige

Author information

Tomomi Kogiso
Institute of Gastroenterology, Department of Internal Medicine, Tokyo Women's Medical University, Japan
Etsuko Hashimoto
Institute of Gastroenterology, Department of Internal Medicine, Tokyo Women's Medical University, Japan
Taito Ito
Institute of Gastroenterology, Department of Internal Medicine, Tokyo Women's Medical University, Japan
Toshifumi Hara
Institute of Gastroenterology, Department of Internal Medicine, Tokyo Women's Medical University, Japan
Yuichi Ikarashi
Institute of Gastroenterology, Department of Internal Medicine, Tokyo Women's Medical University, Japan
Kazuhisa Kodama
Institute of Gastroenterology, Department of Internal Medicine, Tokyo Women's Medical University, Japan
Makiko Taniai
Institute of Gastroenterology, Department of Internal Medicine, Tokyo Women's Medical University, Japan
Nobuyuki Torii
Institute of Gastroenterology, Department of Internal Medicine, Tokyo Women's Medical University, Japan
Kentaro Yoshinaga
Department of Hematology, Tokyo Women's Medical University, Japan
Satoru Morita
Department of Diagnostic Imaging and Nuclear Medicine, Tokyo Women's Medical University, Japan
Yutaka Takahashi
Institute of Gastroenterology, Department of Surgery, Tokyo Women's Medical University, Japan
Junji Tanaka
Department of Hematology, Tokyo Women's Medical University, Japan
Shuji Sakai
Department of Diagnostic Imaging and Nuclear Medicine, Tokyo Women's Medical University, Japan
Masakazu Yamamoto
Institute of Gastroenterology, Department of Surgery, Tokyo Women's Medical University, Japan
Katsutoshi Tokushige
Institute of Gastroenterology, Department of Internal Medicine, Tokyo Women's Medical University, Japan

Keywords: Denver peritoneovenous shunt (PVS), Budd-Chiari syndrome (BCS), paroxysmal nocturnal hemoglobinuria (PNH)

JOURNAL OPEN ACCESS

2016 Volume 55 Issue 20 Pages 2957-2963

DOI https://doi.org/10.2169/internalmedicine.55.7087

Details

Abstract

A 56-year-old man was diagnosed with aplastic anemia and paroxysmal nocturnal hemoglobinuria at 43 years of age and treatment with cyclosporin A was started. Liver cirrhosis, ascites, and thrombus in the hepatic veins were found at 56 years of age and Budd-Chiari syndrome (BCS) was diagnosed according to angiography findings. He was treated with diuretics and paracentesis was performed several times, but with limited efficacy. A Denver^® peritoneovenous shunt (PVS) was inserted into the right jugular vein; his ascites and renal function improved immediately and his general condition has remained good for 12 months since starting the above treatment regimen. A PVS is a treatment option for ascites due to BCS.

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