<?xml version="1.0" encoding="ISO-8859-1"?><article xmlns:mml="http://www.w3.org/1998/Math/MathML" xmlns:xlink="http://www.w3.org/1999/xlink" xmlns:xsi="http://www.w3.org/2001/XMLSchema-instance">
<front>
<journal-meta>
<journal-id>1665-1146</journal-id>
<journal-title><![CDATA[Boletín médico del Hospital Infantil de México]]></journal-title>
<abbrev-journal-title><![CDATA[Bol. Med. Hosp. Infant. Mex.]]></abbrev-journal-title>
<issn>1665-1146</issn>
<publisher>
<publisher-name><![CDATA[Instituto Nacional de Salud, Hospital Infantil de México Federico Gómez]]></publisher-name>
</publisher>
</journal-meta>
<article-meta>
<article-id>S1665-11462015000200124</article-id>
<article-id pub-id-type="doi">10.1016/j.bmhimx.2015.04.001</article-id>
<title-group>
<article-title xml:lang="es"><![CDATA[Síndrome hepatopulmonar como causa de hipoxemia en niños con enfermedad hepática]]></article-title>
<article-title xml:lang="en"><![CDATA[Hepatopulmonary syndrome as a cause of hypoxemia in hepatic diseases in children]]></article-title>
</title-group>
<contrib-group>
<contrib contrib-type="author">
<name>
<surname><![CDATA[Sáenz-Gómez]]></surname>
<given-names><![CDATA[Jessica]]></given-names>
</name>
<xref ref-type="aff" rid="Aff"/>
</contrib>
<contrib contrib-type="author">
<name>
<surname><![CDATA[Karam Bechara]]></surname>
<given-names><![CDATA[José]]></given-names>
</name>
<xref ref-type="aff" rid="Aff"/>
</contrib>
<contrib contrib-type="author">
<name>
<surname><![CDATA[Jamaica Balderas]]></surname>
<given-names><![CDATA[Lourdes]]></given-names>
</name>
<xref ref-type="aff" rid="Aff"/>
</contrib>
</contrib-group>
<aff id="Af1">
<institution><![CDATA[,Hospital Infantil de México Federico Gómez Servicio de Neumología ]]></institution>
<addr-line><![CDATA[México D.F.]]></addr-line>
<country>MX</country>
</aff>
<pub-date pub-type="pub">
<day>00</day>
<month>04</month>
<year>2015</year>
</pub-date>
<pub-date pub-type="epub">
<day>00</day>
<month>04</month>
<year>2015</year>
</pub-date>
<volume>72</volume>
<numero>2</numero>
<fpage>124</fpage>
<lpage>128</lpage>
<copyright-statement/>
<copyright-year/>
<self-uri xlink:href="http://www.scielo.org.mx/scielo.php?script=sci_arttext&amp;pid=S1665-11462015000200124&amp;lng=en&amp;nrm=iso"></self-uri><self-uri xlink:href="http://www.scielo.org.mx/scielo.php?script=sci_abstract&amp;pid=S1665-11462015000200124&amp;lng=en&amp;nrm=iso"></self-uri><self-uri xlink:href="http://www.scielo.org.mx/scielo.php?script=sci_pdf&amp;pid=S1665-11462015000200124&amp;lng=en&amp;nrm=iso"></self-uri><abstract abstract-type="short" xml:lang="es"><p><![CDATA[Resumen:Introducción: El síndrome hepatopulmonar es una complicación rara caracterizada por enfermedad hepática asociada con dilataciones vasculares intrapulmonares e hipoxemia. La prevalencia reportada en los escasos estudios realizados en niños con cirrosis es del 3-8%. Aunque es una entidad poco frecuente, es de suma importancia que el clínico la reconozca debido a su curso progresivo.Caso clínico: Se presenta el caso de una niña de 8 años de edad con diagnóstico de cirrosis hepática e hipertensión portal, con sintomatología de disnea y cianosis. Al examen físico se encontró desnutrida, con ictericia generalizada, telangiectasias en abdomen, hipocratismo digital severo, acrocianosis, platipnea y ortodeoxia. La gasometría arterial con PaO2 de 59 mmHg. El ecocardiograma con test de suero salino agitado resultó positivo y la gammagrafía de perfusión pulmonar con macroagregados de albúmina reportó cortocircuito derecha a izquierda del 15%, demostrándose así la existencia de shunt intrapulmonar. Se integró el diagnóstico de síndrome hepatopulmonar de severidad grave, y se recomendó trasplante hepático como el único tratamiento eficaz.Conclusiones: En niños con enfermedad hepática que presenten disnea e hipoxemia, y en los que estén en protocolo de trasplante hepático, debe de buscarse intencionadamente el síndrome hepatopulmonar, ya que el pronóstico dependerá del diagnóstico oportuno.]]></p></abstract>
<abstract abstract-type="short" xml:lang="en"><p><![CDATA[Abstract:Background: Hepatopulmonary syndrome is a rare complication characterized by liver disease associated with hypoxemia and intrapulmonary vascular dilatations. The prevalence reported in the few studies in children with cirrhosis is 3-8%. Although uncommon, it is important for physicians to recognize this condition because of its progressive course.Case report: We report the case of an 8-year-old girl diagnosed with liver cirrhosis and portal hypertension with symptoms of dyspnea and cyanosis. On physical examination the patient was found malnourished with jaundice, telangiectasias in abdomen, severe clubbing, acrocyanosis, platypnea and orthodeoxia; arterial blood gas showed PaO2 of 59 mmHg. Echocardiography with agitated saline test was positive and lung perfusion scan with albumin macroaggregates reported 15% right-to-left short circuit, thus demonstrating the existence of intrapulmonary shunt. Diagnosis of severe hepatopulmonary syndrome was made. Liver transplantation is recommended as the only effective treatment.Conclusions: In children with liver disease presenting dyspnea and hypoxemia and those enrolled in a liver transplant protocol, hepatopulmonary syndrome must be intentionally searched because the prognosis will depend on timely diagnosis.]]></p></abstract>
<kwd-group>
<kwd lng="es"><![CDATA[Síndrome hepatopulmonar]]></kwd>
<kwd lng="es"><![CDATA[Cirrosis]]></kwd>
<kwd lng="es"><![CDATA[Trasplante hepático]]></kwd>
<kwd lng="es"><![CDATA[Hipoxemia]]></kwd>
<kwd lng="es"><![CDATA[Platipnea]]></kwd>
<kwd lng="es"><![CDATA[Shunt]]></kwd>
<kwd lng="en"><![CDATA[Hepatopulmonary síndrome]]></kwd>
<kwd lng="en"><![CDATA[Hepatic cirrosis]]></kwd>
<kwd lng="en"><![CDATA[Liver transplantation]]></kwd>
<kwd lng="en"><![CDATA[Hypoxemia]]></kwd>
<kwd lng="en"><![CDATA[Platypnea]]></kwd>
<kwd lng="en"><![CDATA[Shunt]]></kwd>
</kwd-group>
</article-meta>
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