Splenectomy-Induced Portal Hypertension and Pulmonary Hypertension
Authors: Marius M. Hoeper, Jost Niedermeyer
Journal: Annals of Internal Medicine (1999)

Letters16 November 1999Splenectomy-Induced Portal Hypertension and Pulmonary HypertensionMarius M. Hoeper, MD and Jost Niedermeyer, MDMarius M. Hoeper, MDHannover Medical School; 30623 Hannover, Germany (Hoeper)Hannover Medical School; 30623 Hannover, Germany (Niedermeyer)Search for more papers by this author and Jost Niedermeyer, MDHannover Medical School; 30623 Hannover, Germany (Hoeper)Hannover Medical School; 30623 Hannover, Germany (Niedermeyer)Search for more papers by this authorAuthor, Article, and Disclosure Informationhttps://doi.org/10.7326/0003-4819-131-10-199911160-00026 SectionsAboutFull TextPDF ToolsAdd to favoritesDownload CitationsTrack CitationsPermissions ShareFacebookTwitterLinkedInRedditEmail IN RESPONSE:We thank Teramoto and colleagues for their comments. Their suggestions about possible mechanisms for the development of pulmonary hypertension after splenectomy are inconclusive. First, the development of portal hypertension after splenectomy is rare, and coexistence of portal hypertension and pulmonary hypertension was thoroughly excluded by Doppler ultrasonography in all our patients. No evidence suggests that abnormal pulmonary vasodilatation as part of the hepatopulmonary syndrome plays any role in splenectomy-associated pulmonary hypertension. Hypoxic vasoconstriction is not a feature of the hepatopulmonary syndrome, and respiratory acidosis is almost never involved.Teramoto and colleagues also stressed the role of impaired regional ...References1. Rolla G, Brussino L, Colagrande P, Dutto L, Polizzi S, Scappaticci E, et al . Exhaled nitric oxide and oxygenation abnormalities in hepatic cirrhosis. Hepatology. 1997;26:842-7. CrossrefMedlineGoogle Scholar2. Krowka MJ. Hepatopulmonary syndrome. Current concepts in diagnostic and therapeutic considerations. Chest. 1994;105:1528-37. CrossrefMedlineGoogle Scholar3. Giaid A, Salch D. Reduced expression of the endothelial nitric oxide synthase in patients with pulmonary hypertension. N Engl J Med. 1995;333:214-2. CrossrefMedlineGoogle Scholar4. Mason NA, Springall DR, Burke M, Pollock J, Yacoub MH, Polak JM. High expression of endothelial nitric oxide synthase in plexiform lesions of pulmonary hypertension. J Pathol. 1998;185:313-8. CrossrefMedlineGoogle Scholar Author, Article, and Disclosure InformationAuthors: Marius M. Hoeper, MD; Jost Niedermeyer, MDAffiliations: Hannover Medical School; 30623 Hannover, Germany (Hoeper)Hannover Medical School; 30623 Hannover, Germany (Niedermeyer) PreviousarticleNextarticle Advertisement FiguresReferencesRelatedDetailsSee AlsoPulmonary Hypertension after Splenectomy? Marius M. Hoeper , Jost Niedermeyer , Frank Hoffmeyer , Peer Flemming , and Helmut Fabel Splenectomy-Induced Portal Hypertension and Pulmonary Hypertension Shinji Teramoto , Takeshi Matsuse , and Yasuyoshi Ouchi Metrics Cited byPulmonary hypertension in patients with hematological disorders following splenectomyPulmonary hypertension in patients with hematological disorders following splenectomy 16 November 1999Volume 131, Issue 10Page: 793KeywordsLigasesPathogenesisPortal hypertensionPulmonary hypertensionPulmonary vascular diseasesSplenectomyThalassemiaUltrasound imagingVasoconstrictionVasodilation ePublished: 15 August 2000 Issue Published: 16 November 1999 Copyright & PermissionsCopyright © 1999 by American College of Physicians. All Rights Reserved.PDF downloadLoading ...