Hepatopulmonary syndrome caused by hypothalamic obesity and nonalcoholic fatty liver disease after surgery for craniopharyngioma: a case report.
10.6065/apem.2018.23.1.51
- Author:
Dai JUNG
1
;
Go Hun SEO
;
Yoon Myung KIM
;
Jin Ho CHOI
;
Han Wook YOO
Author Information
1. Department of Pediatrics, Asan Medical Center Children's Hospital, University of Ulsan College of Medicine, Seoul, Korea. hwyoo@amc.seoul.kr
- Publication Type:Case Report
- Keywords:
Craniopharyngioma;
Hepatopulmonary syndrome;
Hypothalamus;
Nonalcoholic fatty liver disease;
Obesity
- MeSH:
Ambulatory Care Facilities;
Anoxia;
Arteries;
Biopsy;
Comorbidity;
Craniopharyngioma*;
Diabetes Mellitus;
Dyspnea;
Echocardiography;
Emergency Service, Hospital;
Female;
Fibrosis;
Hepatopulmonary Syndrome*;
Humans;
Hypertension, Portal;
Hypothalamus;
Liver;
Liver Diseases;
Liver Transplantation;
Lung;
Non-alcoholic Fatty Liver Disease*;
Obesity*;
Oxygen;
Perfusion;
Tissue Donors;
Weight Loss;
Young Adult
- From:Annals of Pediatric Endocrinology & Metabolism
2018;23(1):51-55
- CountryRepublic of Korea
- Language:English
-
Abstract:
Hypothalamic obesity is often complicated in patients with craniopharyngioma due to hypothalamic damage by the tumor itself, treatment modalities, and associated multiple pituitary hormone deficiency. Hypothalamic obesity causes secondary diseases such as nonalcoholic fatty liver disease (NAFLD) and diabetes mellitus (DM). We report a 19-year-old female who was diagnosed with craniopharyngioma, developed hypothalamic obesity after tumor resection, and progressed to hepatopulmonary syndrome. She manifested NAFLD 1 year after tumor resection. Two years later, the craniopharyngioma recurred, and she underwent a second resection. Three years after her second operation, she was diagnosed with type 2 DM, after which she did not visit the outpatient clinic for 2 years and then suddenly reappeared with a weight loss of 25.8 kg that had occurred over 21 months. One month later, she presented to the Emergency Department with dyspnea. Laboratory findings revealed liver dysfunction and hypoxia with increased alveolar artery oxygen gradient. Liver biopsy showed portal hypertension and micronodular cirrhosis. Echocardiography and a lung perfusion scan demonstrated a right to left shunt. She was finally diagnosed with hepatopulmonary syndrome and is currently awaiting a donor for liver transplantation. Patients surviving craniopharyngioma need to be followed up carefully to detect signs of hypothalamic obesity and monitored for the development of other comorbidities such as DM, NAFLD, and hepatopulmonary syndrome.
