TY - JOUR
AU - Lipman, J.
AB - Intensive Care Med (1999) 25: 1332±1333 CORRESPONDENCE Ó Springer-Verlag 1999 R. Meacher B. Venkatesh J. Lipman Acute respiratory distress syndrome precipitated by transjugular intrahepatic porto-systemic shunting for severe hepatic veno-occlusive disease. Is it due to pulmonary leucostasis? Sir: Up to 54 % of patients undergoing bone marrow transplantation (BMT) de- velop veno-occlusive disease (VOD) of the liver [1]. Recently attempts to treat VOD with trans-jugular intrahepatic shunting (TIPS) have met with some success. We re- port a case of acute respiratory distress syndrome (ARDS) immediately following TIPS for severe VOD ± a previously unre- ported complication. A 40 year old man underwent success- ful allogeneic BMT for non-Hodgkins lym- phoma. and was maintained on 75 mg of cyclosporine daily for GVHD prophylaxis. Following the BMT, he developed severe VOD confirmed on liver biopsy and a he- patic venogram (porto-systemic gradient of 29 mmHg). The haematological profile showed leucopoenia (white cell count (WCC)-1.7 x 10 /l, absolute neutrophil count (ANC) 0.84 x 10 /l, no evidence of left shift) and thrombocytopoenia (26 x 10 / l) consistent with secondary hypersplenism. TIPS was performed (under vancomycin, ceftazidime cover) uneventfully with good stent function and a porto-systemic gradi- ent of 11 mmHg 
TI - Acute respiratory distress syndrome precipitated by transjugular intrahepatic porto-systemic shunting for severe hepatic veno-occlusive disease. Is it due to pulmonary leucostasis?
JF - Intensive Care Medicine
DO - 10.1007/s001340051070
DA - 1999-11-29
UR - https://www.deepdyve.com/lp/springer-journals/acute-respiratory-distress-syndrome-precipitated-by-transjugular-yJWPU6xCCz
SP - 1332
EP - 1333
VL - 25
IS - 11
DP - DeepDyve
ER -