Female sex and autoimmune hepatitis and the risk of portopulmonary hypertension

CASTANO G; SOOKOIAN S

HEPATOLOGY (BALTIMORE, MD.)

United States

Lugar: Wiley; Año: 2008 vol. 48 p. 2090 - 2090

0270-9139

In a series of 90 outpatients with cirrhosis we evaluated the presence of portopulmonary hypertension (PPHTN) and analyzed the relationship between hemodynamic parameters and the etiology of liver disease. Patients showed a mean age of 52 years (19- 72); 60 patients were Child Pough class A, 18 class B and 12 class C. Eight out of 90 patients showed mean pulmonary artery pressure (mPAP) higher than 25 mm Hg. However, only two patients fulfilled the criteria of PPHTN. The two patients with PPHTN were young females, aged 19 and 30 years respectively, having autoimmune hepatitis. In the whole sample, patients with autoimmune hepatitis or primary biliary cirrhosis were mostly females (13/ 15), and they were younger (44± 15 SD vs. 54± 9 SD years; p=0.001) and showed higher mPAP (22.5± 8.8 SD vs. 17.9± 7.2 SD mmHg; p=0.03) and pulmonary vascular resistance (PVR) (246± 209 SD vs.143± 63 SD dynes·s·cm–5; p=0.008) than patients with cirrhosis caused by other etiologies. Patients with hepatitis C showed lower mPAP than other etiologies (16.3 ± 5 SD vs. 19.8 ± 8 SD, p= 0.04). No correlation was found between mPAP and other portal or systemic hemodynamic parameter or with severity of liver disease, but a negative correlation was found with age (r – 0.28; p< 0.05). In summary, we observed that young females with autoimmune hepatitis might have an increased risk of developing PPHTN in comparison with patients with advanced liver disease of other etiologies.