Korean J Gastroenterol.  2020 Feb;75(2):98-102. 10.4166/kjg.2020.75.2.98.

Refractory Hepatic Hydrothorax in Chronic Hepatitis C Controlled by Direct-acting Antivirals

• Kim MH
• Kim DK
• Eun HS
• Rou WS
• Kim SH
• Lee BS

• KMID: 2471149
• DOI: http://doi.org/10.4166/kjg.2020.75.2.98

Abstract

Hepatic hydrothorax is a transudative pleural effusion that complicates advanced liver cirrhosis. Patients refractory to medical treatment plus salt restriction and diuretics are considered to have refractory hepatic hydrothorax and may require transjugular intrahepatic portosystemic shunt (TIPS) or liver transplant. Successful antiviral therapy reduces the incidence of some complications of cirrhosis secondary to HCV infection. We report a case of hepatic hydrothorax in a 55-year-old female patient with HCV cirrhosis, which exhibited a spontaneous decrease in pleural effusion after direct antiviral agent (DAA) therapy. In cases of HCV cirrhosis, DAAs are worth administering before treatment by TIPS or liver transplantation.

Keyword

Hydrothorax; Liver cirrhosis; Hepacivirus; Pleural effusion

MeSH Terms

Antiviral Agents*
Diuretics
Female
Fibrosis
Hepacivirus
Hepatitis C, Chronic*
Hepatitis, Chronic*
Humans
Hydrothorax*
Incidence
Liver
Liver Cirrhosis
Liver Transplantation
Middle Aged
Pleural Effusion
Portasystemic Shunt, Surgical
Antiviral Agents
Diuretics

Figure

• 

  Fig. 1. Abdomen computed tomography finding at admission. The liver was shrunken and showed surface nodularity, and a moderate amount of ascites was noted near the liver. Right massive pleural effusion post pigtail catheter drainage.

• 

  Fig. 2. Serial chest X-ray findings of hepatic hydrothorax. (A) A large amount of fluid had collected in the right pleural cavity at admission. (B) Insertion of a pigtail catheter in the right pleural cavity (C) resulted in complete effusion drainage. (D) At 1 month after discharge, no residual effusion was noted. PA, posteroanterior.

Reference

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