難治性腹水に選択的β₁-blockerが有効であったBudd-Chiari症候群の一例

Abstract

A 36-year-old female with Budd-Chiari syndrome who had refractory ascites and hepatic failure is reported. Sodium restriction, infusion of albumin, and administration of various diuretics were not effective. Because the effect of β-blocker on portal hypertension had been reported and portal hypertension was considered to be one of the main causes for ascites in this case, selective β₁-blocker metoprolol (80 mg/day) was added to diuretics. As a result, her ascites rapidly disappeared. Selective β₁-blocker has no adverse effect on hepatic blood flow, and therefore was considered to be relatively safe for patients with severe liver disturbance. Selective β₁- blocker seems to be promising in the treatment of refractory ascites, for which portal hypertension has a major pathogenetic role.