# Haemoptysis as a Presenting Manifestation of Hepatopulmonary Syndrome With Complete Resolution After Liver Transplantation

## TL;DR

A patient with liver disease showed haemoptysis as a rare symptom of hepatopulmonary syndrome, which resolved after a liver transplant.

## Contribution

Haemoptysis is reported as a rare presenting feature of hepatopulmonary syndrome, with resolution after liver transplantation.

## Key findings

- Contrast echocardiography confirmed intrapulmonary shunting in a patient with hepatopulmonary syndrome.
- Haemoptysis and hypoxemia resolved completely after liver transplantation.
- This case highlights an unusual clinical presentation of hepatopulmonary syndrome.

## Abstract

Hepatopulmonary syndrome (HPS) is a pulmonary vascular complication of chronic liver disease characterised by intrapulmonary vascular dilatation and hypoxemia. Dyspnoea and orthodeoxia are classic features, while haemoptysis is rarely reported. We describe a patient with cirrhosis who presented with recurrent haemoptysis and progressive hypoxemia. Contrast‐enhanced transthoracic echocardiography demonstrated intrapulmonary right‐to‐left shunting, which resolved following orthotopic liver transplantation, with complete cessation of haemoptysis.

Hepatopulmonary syndrome rarely presents with haemoptysis. This case demonstrates haemoptysis as a presenting manifestation of HPS, with intrapulmonary shunting documented on contrast echocardiography before liver transplantation and complete resolution after transplantation.