Decompensated Cirrhosis with Hepatopulmonary Syndrome in a Patient with Interrupted Treatment for Hypopituitarism: A Case Report

Tomoko Tadokoro; Joji Tani; Yudai Sato; Rie Yano; Kei Takuma; Mai Nakahara; Kyoko Oura; Koji Fujita; Masafumi Ono; Atsushi Tobiume; Seisuke Sato; Takuya Inoue; Asahiro Morishita; Hideki Kobara

doi:10.2169/internalmedicine.4753-24

Tomoko Tadokoro, Joji Tani, Yudai Sato, Rie Yano, Kei Takuma, Mai Nakahara, Kyoko Oura, Koji Fujita, Masafumi Ono, Atsushi Tobiume, Seisuke Sato, Takuya Inoue, Asahiro Morishita, Hideki Kobara

Author information

Tomoko Tadokoro
Department of Gastroenterology and Neurology, Faculty of Medicine, Kagawa University, Japan
Joji Tani
Department of Gastroenterology and Neurology, Faculty of Medicine, Kagawa University, Japan
Yudai Sato
Department of Gastroenterology and Neurology, Faculty of Medicine, Kagawa University, Japan
Rie Yano
Department of Gastroenterology and Neurology, Faculty of Medicine, Kagawa University, Japan
Kei Takuma
Department of Gastroenterology and Neurology, Faculty of Medicine, Kagawa University, Japan
Mai Nakahara
Department of Gastroenterology and Neurology, Faculty of Medicine, Kagawa University, Japan
Kyoko Oura
Department of Gastroenterology and Neurology, Faculty of Medicine, Kagawa University, Japan
Koji Fujita
Department of Gastroenterology and Neurology, Faculty of Medicine, Kagawa University, Japan
Masafumi Ono
Department of Gastroenterology and Neurology, Faculty of Medicine, Kagawa University, Japan
Atsushi Tobiume
Department of Cardiorenal and Cerebrovascular Medicine, Faculty of Medicine, Kagawa University, Japan
Seisuke Sato
Department of Endocrinology and Metabolism, Faculty of Medicine, Kagawa University, Japan
Takuya Inoue
Department of Internal Medicine, Division of Hematology, Rheumatology, and Respiratory Medicine, Faculty of Medicine, Kagawa University, Japan
Asahiro Morishita
Department of Gastroenterology and Neurology, Faculty of Medicine, Kagawa University, Japan
Hideki Kobara
Department of Gastroenterology and Neurology, Faculty of Medicine, Kagawa University, Japan

Keywords: liver cirrhosis, growth hormone, adult growth hormone deficiency, panhypopituitarism, craniopharyngioma, hepatopulmonary syndrome

JOURNAL OPEN ACCESS Advance online publication

Article ID: 4753-24

DOI https://doi.org/10.2169/internalmedicine.4753-24

Details

Abstract

A 32-year-old man presented with cirrhosis. At 8 years of age, he underwent resection of a craniopharyngioma, which resulted in panhypopituitarism. He underwent self-interrupted hormone replacement therapy at 20 years of age. Computed tomography revealed severe fatty liver and cirrhosis. An endocrinological evaluation revealed panhypopituitarism. Further assessment revealed a diagnosis of hepatopulmonary syndrome. Home oxygen therapy and hormone replacement therapy were initiated. Despite these efforts, poorly controlled hypothalamic obesity led to liver failure, and the patient is currently awaiting liver transplantation. Liver cirrhosis associated with long-term panhypopituitarism may have a poor prognosis even with hormone replacement therapy.

Corresponding author

Register with J-STAGE for free!