Are the Spider Angiomas Skin Markers of Hepatopulmonary Syndrome?

Abstract

Context Hepatopathies can significantly influence both veins and arteries, these changes may cause some cutaneous stigmas, such as spider angioma (SA) and some systemic vascular changes, such as those observed in hepatopulmonary syndrome (HPS). Based on this common pathophysiological root we can assume that the SA can be skin markers of HPS. Objective The objective of this study is to assess whether there is a relationship between the presence of SA and HPS. Methods Records of 40 patients with liver cirrhosis who underwent contrast echocardiography were evaluated, in which we researched the description of SA, physical examination, and other clinical and laboratory data. For diagnosis of HPS we use these signs of the disease: presence of liver disease (cirrhosis in the case), abnormalities in gas exchange by arterial blood gases, and evidence of pulmonary vasodilations by the contrast echocardiography. Results The SA were found in 21/40 (52.5%) patients and hepatopulmonary syndrome in 9/40 (22.5%). The HPS was observed in 8/21 (38.1%) of patients with SA and 1/19 (5.3%) patients were without this sign (P<0.01). We found no statistically significant difference between the SA and the presence of HPS with sex or age. Patients with SA had a higher hypoxemia [PaO2 84.8 ± 11.5 mmHg and 19.8 ± 14.7 mmHg alveolar-arterial gradient of oxygen (AAG)] than those without SA (PaO2 90.8 ± 10.7 mmHg and 10.9 ± 11.7 AAG mmHg) (P<0.05). Conclusion Our findings show a correlation between the presence of SA and HPS, suggesting that the SA may be cutaneous markers of HPS.

MIR196A2 rs11614913 C > T polymorphism correlates with an increased risk of hepatopulmonary syndrome in liver cirrhosis: a case–control study in China

“…Silvério Ade et al . reported that spider nevus is a potential maker of HPS . This study also found that the presence of CT + CC genotype enhanced the risk of developing combined liver cirrhosis and HPS for people with older age (≥45 years), drinking history, smoking history, drug history of liver injury, overwork, or virus infection.…”

Hepatopulmonary Syndrome and Liver Transplantation: A Recent Review of the Literature

“…This can be due to the same imbalance between vasodilators and vasoconstrictors. 61 Usually, oxygen desaturation occurs during sleep in HPS patients, and the degree of hypoxemia correlates with the severity of HPS. 62 Other physical signs, such as cirrhosis and portal hypertension, can be seen in patients with HPS.…”

Cryptogenic Cirrhosis and Hepatopulmonary Syndrome in a Boy with Hepatic Hemangioma in Botswana: A Case Report and Review of the Literature

“…Cyanosis has a negative predictive value of 97% while finger clubbing has been reported to have a negative predictive value of up to 75% [ 11 ]. Our patient did not have spider angiomas, although they have been widely described as cutaneous markers of the hepatopulmonary syndrome, especially in the setting of intrapulmonary vascular dilatations [ 11 , 12 ].…”