Hypoxemia and if it is the liver? Hepatopulmonary syndrome : about a case.

The hepatopulmonary syndrome is defined as the triad of liver disease, pulmonary gas exchange abnormalities leading to arterial deoxygenation and widespread pulmonary vascular dilatation. It is one of the not infrequently cases of dyspnea within patients with liver disease. We report the case of a 32-year-old woman with cirrohsis and portal hypertention who presented with dyspnea worsning progressively. The blood gas revealed a deep hypoxemia with a PaO2 rate 42mmHg but clinically well tolerated. Pulmonary embolism and pneumonia were rapidly excluded by a CT pulmonary angiography. An echocadiography done in order to find any heart disease suspected a patent foramen ovale. A transthoracic contrast echocardiography showed an important pulmonary vascular dilatation.The association of cirrohsis, pulmonary vascular dilatation and hypoxemia made the diagnos of hepatopulmonary syndrome.

[Diffuse infiltrating lung disease secondary to antisynthetase syndrome: a case report]. / Pneumopathie infiltrante diffuse secondaire à un syndrome des antisynthétases: à propos d´un cas.

Diffuse infiltrate lung diseases (DILDs) are frequent in patients with connective tissue diseases. They can be suggestive of connective tissue diseases or occur during follow-up. Antisynthetase syndrome (ASS) is a complex and heterogeneous connective tissue disease. Antisynthetase antibodies, in particular the anti-Jo1 antibody, are found in patients with this syndrome. The prognosis of ASS is conditioned by the occurrence of DILD and its severity, thus guiding therapeutic management. We here report the case of a 57-year-old female patient presenting with acute febrile DILD revealing ASS. Outcome was favorable under bolus corticosteroids in combination with cyclophosphamide treatment.