Growth hormone cocktail improves hepatopulmonary syndrome secondary to hypopituitarism: A case report

Table 1 Hormone, respiratory data, and hepatitis B screening on admission

Hormone data	Value	Respiratory data	Value	HBV serologic testing	Value
TSH (0.380-4.340 μU/mL)	4.595	FVC	3.15 L	HBsAg	-
FT3 (1.80-4.10 pg/mL)	1.62	%VC	55%	HBsAb	-
FT4 (0.81-1.89 pg/mL)	4.05	FEV1.0	2.63L	HBeAg	-
GH (< 2.0 ng/mL)	< 0.05	FEV1.0%	84%	HBeAb	-
IGF-1 (ng/mL)	32 (115-307)	%DLCO	36.5%	HBcAb	-
ACTH (8 am, pg/mL)	10.3
Cortisol (8 am, 4.26-24.85 μg/dL)	20.06
FSH (1.27-19.26 U/L)	0.35
LH (1.24-8.62 U/L)	0.21
Testosterone (1.75-7.81 ng/mL)	< 0.1
Estradiol (< 47 pg/mL)	6.8
Progesterone (0.10-0.84 ng/mL)	< 0.08
Prolactin (2.6-13.1 ng/mL)	14.18

TSH: Thyroid stimulating hormone; FT3: Free triiodothyronine; FT4: Free thyroxine; ACTH: Adrenocorticotropic hormone; FSH: Follicle stimulating hormone; LH: Luteinizing hormone; FVC: Forced vital capacity; VC: Vital capacity; FEV: Forced expiratory volume; DLCO: Diffusing capacity of the lung for carbon monoxide; HBsAg: Hepatitis B surface antigen; HBsAb: Hepatitis B surface antibody; HBeAg: Hepatitis B e antibody; HBeAb: Hepatitis B e antibody; HBcAb: Hepatitis B core antibody; -: Negative.

Table 2 Changes of liver function and metabolism before and after hormonal treatment

Blood gas analysis on room air	Baseline	Post-treatment	Liver function	Baseline	Post-treatment	Metabolic parameters	Baseline	Post-treatment
pH (7.35-7.45)	7.42	7.42	Alb (35-52g/L)	43	44	TG (0.45-1.70 mmol/L)	2.14	1.36
PCO2 (35-45 mmHg)	34.0	34.6	Tbil (5.1-22.2 μmol/L)	37.0	30.4	TC (2.85-5.70 mmol/L)	6.71	5.92
PO2 (83-108 mmHg)	37.0	71.1	Dbil (0-6.8 μmol/L)	9.6	7.2	LDL-c (< 3.37 mmol/L)	4.70	4.43
SaO2 (95%-99%)	78%	93.1%	GGT (0-40 U/L)	70	64	HDL-c (0.93-1.81 mmol/L)	0.91	0.80
BE (-3.0 ± 3.0 mmol/L)	-7.2	-2.0	ALP (45-125 U/L)	65	80	Fasting-insulin (5.2 - 17.2 μU/mL)	29.1	26.6
HCO-3 (22.0-27.0 mmol/L)	17.7	22.7	ALT (9-50 U/L)	58	47	Fasting blood glucose (3.9-6.1 mmol/L)	6.00	5.60
P(A-a)O2 (5.0-15.0 mmHg)	70.2	35.7	AST (15-40 U/L)	45	32	HbA1c (4.5%-6.3%)	7.4%	7.1%
Intrapulmonary shunt ratio(1.0%-10.0%)	64.4%	9.0%	PIIINP (< 15.00 ng/mL)	13.50	15.21	Na (135-145 mmol/L)	142	138
			CIV (< 95.00 ng/mL)	356.30	46.88	CRP (< 3.00 mg/L)	5.12	0.79
			HA (< 120.00 ng/mL)	73.50	51.83

BE: Base excess; P_(A-a)O₂: Alveolar–arterial oxygen gradient; Alb: Albumin; TBil: Total bilirubin; DBil: Direct bilirubin; GGT: Gamma-glutamyl transpeptidase; ALP: Alkaline phosphatase; ALT: Alkaline phosphatase; AST: Aspartate aminotransferase; PIIINP: Procollagen III N-terminal peptide; CIV: Collagen type IV; HA: Hyaluronic acid; TG: Triglyceride; TC: Total cholesterol; LDL-c: Low-density lipoprotein cholesterol; HDL-c: High-density lipoprotein cholesterol; HbA1c: Hemoglobin A1c; CRP: C-reactive protein.