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Liver transplantation for a patient with Turner syndrome presenting severe portal hypertension: a case report and literature review

BACKGROUND: Liver involvement in Turner syndrome (TS) patients has been more clearly clarified in recent years. Most of the clinical manifestations in TS are asymptomatic and can be detected as liver test abnormalities; however, a few cases may present with end-stage liver disease and thus require l...

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Autores principales: Kawabata, Seiichi, Sakamoto, Seisuke, Honda, Masaki, Hayashida, Shintaro, Yamamoto, Hidekazu, Mikami, Yoshiki, Inomata, Yukihiro
Formato: Online Artículo Texto
Lenguaje:English
Publicado: Springer Berlin Heidelberg 2016
Materias:
Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4927526/
https://www.ncbi.nlm.nih.gov/pubmed/27358061
http://dx.doi.org/10.1186/s40792-016-0194-x
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author Kawabata, Seiichi
Sakamoto, Seisuke
Honda, Masaki
Hayashida, Shintaro
Yamamoto, Hidekazu
Mikami, Yoshiki
Inomata, Yukihiro
author_facet Kawabata, Seiichi
Sakamoto, Seisuke
Honda, Masaki
Hayashida, Shintaro
Yamamoto, Hidekazu
Mikami, Yoshiki
Inomata, Yukihiro
author_sort Kawabata, Seiichi
collection PubMed
description BACKGROUND: Liver involvement in Turner syndrome (TS) patients has been more clearly clarified in recent years. Most of the clinical manifestations in TS are asymptomatic and can be detected as liver test abnormalities; however, a few cases may present with end-stage liver disease and thus require liver transplantation (LT). To the best of our knowledge, only three cases undergoing LT for liver involvements in TS have been previously reported. CASE PRESENTATION: A 30-year-old female successfully underwent living donor LT for liver dysfunction related to TS syndrome. The diagnosis of TS was established by a cytogenetic analysis at 16 years of age. She received several sessions of endoscopic therapy for recurrent esophageal varices, which was complicated by ascites and spontaneous bacterial peritonitis since 27 years of age. Radiological findings of her liver before LT chronologically showed the progression of atrophy with disturbance of the major portal inflow. And then, she was finally indicated for LT. Pathologic findings of the explanted liver showed vascular abnormalities, obliterative portal venopathy, which may have induced liver dysfunction with severe portal hypertension. The patient’s postoperative course was uneventful. CONCLUSIONS: The clinicopathologic information obtained by the current case can provide an insight into understanding pathophysiological mechanisms of liver involvement in TS patients. TS patients presenting with severe liver atrophy and disturbance of the major portal inflow should be indicated for LT.
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spelling pubmed-49275262016-07-06 Liver transplantation for a patient with Turner syndrome presenting severe portal hypertension: a case report and literature review Kawabata, Seiichi Sakamoto, Seisuke Honda, Masaki Hayashida, Shintaro Yamamoto, Hidekazu Mikami, Yoshiki Inomata, Yukihiro Surg Case Rep Case Report BACKGROUND: Liver involvement in Turner syndrome (TS) patients has been more clearly clarified in recent years. Most of the clinical manifestations in TS are asymptomatic and can be detected as liver test abnormalities; however, a few cases may present with end-stage liver disease and thus require liver transplantation (LT). To the best of our knowledge, only three cases undergoing LT for liver involvements in TS have been previously reported. CASE PRESENTATION: A 30-year-old female successfully underwent living donor LT for liver dysfunction related to TS syndrome. The diagnosis of TS was established by a cytogenetic analysis at 16 years of age. She received several sessions of endoscopic therapy for recurrent esophageal varices, which was complicated by ascites and spontaneous bacterial peritonitis since 27 years of age. Radiological findings of her liver before LT chronologically showed the progression of atrophy with disturbance of the major portal inflow. And then, she was finally indicated for LT. Pathologic findings of the explanted liver showed vascular abnormalities, obliterative portal venopathy, which may have induced liver dysfunction with severe portal hypertension. The patient’s postoperative course was uneventful. CONCLUSIONS: The clinicopathologic information obtained by the current case can provide an insight into understanding pathophysiological mechanisms of liver involvement in TS patients. TS patients presenting with severe liver atrophy and disturbance of the major portal inflow should be indicated for LT. Springer Berlin Heidelberg 2016-06-29 /pmc/articles/PMC4927526/ /pubmed/27358061 http://dx.doi.org/10.1186/s40792-016-0194-x Text en © The Author(s). 2016 Open AccessThis article is distributed under the terms of the Creative Commons Attribution 4.0 International License (http://creativecommons.org/licenses/by/4.0/), which permits unrestricted use, distribution, and reproduction in any medium, provided you give appropriate credit to the original author(s) and the source, provide a link to the Creative Commons license, and indicate if changes were made.
spellingShingle Case Report
Kawabata, Seiichi
Sakamoto, Seisuke
Honda, Masaki
Hayashida, Shintaro
Yamamoto, Hidekazu
Mikami, Yoshiki
Inomata, Yukihiro
Liver transplantation for a patient with Turner syndrome presenting severe portal hypertension: a case report and literature review
title Liver transplantation for a patient with Turner syndrome presenting severe portal hypertension: a case report and literature review
title_full Liver transplantation for a patient with Turner syndrome presenting severe portal hypertension: a case report and literature review
title_fullStr Liver transplantation for a patient with Turner syndrome presenting severe portal hypertension: a case report and literature review
title_full_unstemmed Liver transplantation for a patient with Turner syndrome presenting severe portal hypertension: a case report and literature review
title_short Liver transplantation for a patient with Turner syndrome presenting severe portal hypertension: a case report and literature review
title_sort liver transplantation for a patient with turner syndrome presenting severe portal hypertension: a case report and literature review
topic Case Report
url https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4927526/
https://www.ncbi.nlm.nih.gov/pubmed/27358061
http://dx.doi.org/10.1186/s40792-016-0194-x
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