Hepatopulmonary syndrome differential diagnosis
Editor-In-Chief: C. Michael Gibson, M.S., M.D. [1]; Associate Editor(s)-in-Chief: Soroush Seifirad, M.D.[2]
Overview
Hepatopulmonary syndrome (HPS) must be differentiated from portopulmonary hypertension (PPH) and hereditary hemorrhagic telangiectasia (HHT).
Differentiating Hepatopulmonary Syndrome from other Diseases
Hepatopulmonary syndrome (HPS) must be differentiated from portopulmonary hypertension (PPH) and hereditary hemorrhagic telangiectasia (HHT).
Differentiating hepatopulmonary syndrome from other diseases on the basis of pulse oximetry, arterial blood gas (ABG) analysis , contrast enhanced echocardiography; 99mTc scan: lung perfusion scintigraphy with technetium 99mTc labeled macro aggregated albumin, chest CT scan , pulmonary angiography, and pulmonary function test.
On the basis pulse oximetry, arterial blood gas (ABG) analysis , contrast enhanced echocardiography; 99mTc scan: lung perfusion scintigraphy with technetium 99mTc labeled macro aggregated albumin, chest CT scan , pulmonary angiography, and pulmonary function test, hepatopulmonary syndrome (HPS) must be differentiated from portopulmonary hypertension (PPH) and hereditary hemorrhagic telangiectasia (HHT).
| Diseases | Clinical manifestations | Para-clinical findings | Gold standard | Additional findings | ||||||||||
|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|
| Symptoms | Physical examination | |||||||||||||
| Lab Findings | Imaging | Histopathology | ||||||||||||
| Respiratory symptoms including, shortness of breath, clubbed fingers, and cyanosis. | Chronic liver disease symptoms including,
Itching, easy bruising, abdominal fullness, decreased libido, abdominal distension, and fatigue. |
Platypnea | Orthodeoxia | Chronic liver disease signs
including, spider angioma, red palms, edema, gynecomastia |
Lab 1 | Lab 2 | Lab 3 | Imaging 1 | Imaging 2 | Imaging 3 | ||||
| Differential Diagnosis 1 | ||||||||||||||
| Differential Diagnosis 2 | ||||||||||||||
| Differential Diagnosis 3 | ||||||||||||||
| Diseases | Respiratory symptoms including, shortness of breath, clubbed fingers, and cyanosis. | Chronic liver disease symptoms including,
Itching, easy bruising, abdominal fullness, decreased libido, abdominal distension, and fatigue. |
Platypnea | Orthodeoxia | Chronic liver disease signs
including, spider angioma, red palms, edema, gynecomastia |
Lab 1 | Lab 2 | Lab 3 | Imaging 1 | Imaging 2 | Imaging 3 | Histopathology | Gold standard | Additional findings |
| Differential Diagnosis 4 | ||||||||||||||
| Differential Diagnosis 5 | ||||||||||||||
| Differential Diagnosis 6 | ||||||||||||||
Platypnea (increased shortness of breath when the body is in a vertical position) and orthodeoxia (3-10 mmHg reduction in РаО2 in capillary blood during transition from horizontal to vertical position)