Arun J. Sanyal, MD; Arthur M. Freedman, MD; Preston P. Purdum III, MD
To the Editors: Transjugular intrahepatic portosystemic shunts (TIPS) are being increasingly used for the treatment of portal hypertension (1). Although effective, the potential morbidity from this procedure has not been extensively studied. We report a case of progressive encephalopathy and hemolytic anemia caused by intravascular hemolysis related to TIPS.
A 48-year-old Korean man with cirrhosis secondary to chronic hepatitis C was referred for evaluation for orthotopic liver transplantation after developing progressive fatigue and hypoalbuminemia. During evaluation for transplantation, he was hospitalized for hematemesis. After hemodynamic stabilization, endoscopy showed esophageal varices with a fibrin clot and oozing. Bleeding was controlled by
Sanyal AJ, Freedman AM, Purdum PP. TIPS-associated Hemolysis and Encephalopathy. Ann Intern Med. ;117:443–444. doi: 10.7326/0003-4819-117-5-443
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Published: Ann Intern Med. 1992;117(5):443-444.
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Print ISSN: 0003-4819 | Online ISSN: 1539-3704
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