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Epoprostenol-Induced Hypersplenism in Portopulmonary Hypertension.
MedLine Citation:
PMID:  22227513     Owner:  NLM     Status:  Publisher    
Abstract/OtherAbstract:
Portopulmonary hypertension (POPH) is a not infrequent but serious complication of liver cirrhosis. Continuous intravenous epoprostenol infusion is a treatment option for this condition. Progressive splenomegaly with pancytopenia (hypersplenism) is associated with epoprostenol use in POPH. After recognizing a case of epoprostenol-induced hypersplenism that resolved upon stopping the drug, the authors retrospectively reviewed all patients treated with epoprostenol at the center for both POPH and pulmonary hypertension due to other causes. Five of 11 patients with POPH developed hypersplenism secondary to epoprostenol. In 1 patient, and possibly in a second, the hypersplenism resolved upon discontinuation of epoprostenol. None of 9 patients with pulmonary hypertension due to other causes developed splenomegaly. This report confirms hypersplenism as a complication of epoprostenol therapy for POPH. Furthermore, the authors demonstrate for the first time that hypersplenism may be reversed by stopping the medication and propose a mechanism for this phenomenon.
Authors:
Waseem Touma; Ravi P Nayak; Zulfiqar Hussain; Bruce R Bacon; Ganesh C Kudva
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Publication Detail:
Type:  JOURNAL ARTICLE     Date:  2012-1-6
Journal Detail:
Title:  The American journal of the medical sciences     Volume:  -     ISSN:  1538-2990     ISO Abbreviation:  -     Publication Date:  2012 Jan 
Date Detail:
Created Date:  2012-1-9     Completed Date:  -     Revised Date:  -    
Medline Journal Info:
Nlm Unique ID:  0370506     Medline TA:  Am J Med Sci     Country:  -    
Other Details:
Languages:  ENG     Pagination:  -     Citation Subset:  -    
Affiliation:
Divisions of Pulmonary and Critical Care Medicine (RPN), Gastroenterology and Hepatology (BRB) and Hematology and Oncology (GCK), Department of Internal Medicine (WT, ZH), Saint Louis University School of Medicine, St. Louis, Missouri.
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