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We report a challenging case of a 27-year-old man with a background of hypopituitarism with no known liver disease who presented with progressive dyspnoea and hypoxaemia and was eventually diagnosed with severe HPS.<\/jats:p>","DOI":"10.1136\/bcr-2021-244805","type":"journal-article","created":{"date-parts":[[2021,9,20]],"date-time":"2021-09-20T12:05:40Z","timestamp":1632139540000},"page":"e244805","update-policy":"https:\/\/doi.org\/10.1136\/crossmarkpolicy","source":"Crossref","is-referenced-by-count":4,"title":["Hepatopulmonary syndrome as the first and only manifestation of cirrhosis in a patient with hypopituitarism"],"prefix":"10.1136","volume":"14","author":[{"ORCID":"https:\/\/orcid.org\/0000-0002-0645-4666","authenticated-orcid":false,"given":"Eman","family":"Alabsawy","sequence":"first","affiliation":[{"name":"Department of Gastroenterology, Guy's and St Thomas' NHS Foundation Trust, London, UK"},{"name":"Faculty of Medicine, Alexandria University, Alexandria, Egypt"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Yassen","family":"Serry","sequence":"additional","affiliation":[{"name":"Department of Gastroenterology, Guy's and St Thomas' NHS Foundation Trust, London, UK"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Sreelakshmi","family":"Kotha","sequence":"additional","affiliation":[{"name":"Department of Gastroenterology, Guy's and St Thomas' NHS Foundation Trust, London, UK"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Philip","family":"Berry","sequence":"additional","affiliation":[{"name":"Department of Gastroenterology, Guy's and St Thomas' NHS Foundation Trust, London, UK"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Giovanni","family":"Tritto","sequence":"additional","affiliation":[{"name":"Department of Gastroenterology, Guy's and St Thomas' NHS Foundation Trust, London, UK"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"239","published-online":{"date-parts":[[2021,9,20]]},"reference":[{"key":"2025082713240760000_14.9.e244805.1","doi-asserted-by":"crossref","first-page":"794","DOI":"10.3345\/kjp.2007.50.8.794","article-title":"A case of hepatopulmonary syndrome in a child with fatty liver disease secondary to hypopituitarism after craniopharyngioma resection","volume":"50","author":"Im","year":"2007","journal-title":"Korean J Pediatr"},{"key":"2025082713240760000_14.9.e244805.2","doi-asserted-by":"crossref","first-page":"1","DOI":"10.1155\/2016\/9071097","article-title":"Panhypopituitarism due to absence of the pituitary stalk: a rare aetiology of liver cirrhosis","volume":"2016","author":"Gonzalez Rozas","year":"2016","journal-title":"Case Rep Endocrinol"},{"key":"2025082713240760000_14.9.e244805.3","doi-asserted-by":"crossref","unstructured":"Rubin MIN FM . 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