Growth hormone cocktail improves hepatopulmonary syndrome secondary to hypopituitarism:A case report  

作　　者：Wen Ji Min Nie Jiang-Feng Mao Hong-Bing Zhang Xi Wang Xue-Yan Wu 

机构地区：[1]Department of Endocrinology,Peking Union Medical College Hospital,Chinese Academy of Medical Sciences and Peking Union Medical College,Beijing 100730,China [2]Department of Endocrinology,Peking Union Medical College Hospital,Beijing 100730,China [3]Department of Physiology,Collaborative Innovation Center for Cancer Medicine,Institute of Basic Medical Sciences and School of Basic Medicine,Beijing 100005,China

出　　处：《World Journal of Clinical Cases》2021年第18期4852-4858,共7页世界临床病例杂志

基　　金：Supported by the National Natural Science Foundation of China,No.81771576 and No.81971375;the Beijing Municipal Natural Science Foundation,No.7202151 and No.7212080.

摘　　要：BACKGROUND Metabolic associated fatty liver disease frequently occurs in patients with hypopituitarism and growth hormone(GH)deficiency.Some patients may develop to hepatopulmonary syndrome(HPS).HPS has a poor prognosis and liver transplantation is regarded as the only approach to cure it.CASE SUMMARY A 29-year-old man presented with progressive dyspnea for 1 mo.At the age of 10 years,he was diagnosed with panhypopituitarism associated with pituitary stalk interruption syndrome.Levothyroxine and hydrocortisone were given since then.To achieve ideal height,he received GH treatment for 5 years.The patient had an oxygen saturation of 78%and a partial pressure of arterial oxygen of 37 mmHg with an alveolar–arterial oxygen gradient of 70.2 mmHg.Abdominal ultrasonography showed liver cirrhosis and an enlarged spleen.Perfusion lung scan demonstrated intrapulmonary arteriovenous right-to-left shunt.HPS(very severe)was our primary consideration.His hormonal evaluation revealed GH deficiency and hypogonadotropic hypogonadism when thyroid hormone,cortisol,and desmopressin were administrated.After adding with long-acting recombinant human GH and testosterone for 14 mo,his liver function and hypoxemia were improved and his progressive liver fibrosis was stabilized.He was off the waiting list of liver transplantation.CONCLUSION Clinicians should screen HPS patients'anterior pituitary function as early as possible and treat them primarily with GH cocktail accordingly.

关 键 词：Hepatopulmonary syndrome TESTOSTERONE Growth hormone Intrapulmonary shunt Insulin-like growth factor Case report 

分 类 号：R584[医药卫生—内分泌] R575[医药卫生—内科学] R563[医药卫生—临床医学]