Recurrent Infected Bronchiectasis in Poorly Controlled Patient Leading to Cardio Hepatorenal Syndrome

Abstract

Background: Cardio hepatorenal syndrome is a severe condition due to chronic congestive heart failure complications characterized by liver and kidney function impairment, however, this condition has a potentially reversible complication.Bronchiectasis as a chronic lung disease was a burden for the healthcare system, especially involving other organs like heart, liver, and renal function. Those conditions were complicated and created a quandary regarding the effective treatments to improve the clinical condition and reduce morbidity and mortality.

Case illustration: A 42-year-old man developed cardio hepatorenal syndrome (CHRS), which may have occurred from recurrent infected bronchiectasis that he had. His HRCT scan of the thorax with contrast showed multiple dilated bronchiwith tram track and signet ring appearance with decreased liver and renal function in laboratory findings, and probability of pulmonary hypertension (PH) and right heart failure (RHF) in echocardiography examination. The diuretic, beta-blocker, and antibiotics were given. During hospitalization, there was improvement day by day not only in his clinical condition but also in his liver and renal function. He has used oxygen as needed, and there was no longer any indication for him to be hospitalized.

Conclusion: Patients with chronic lung diseases like bronchiectasis could have decreased lung function, which developed into other connected organ functions, like heart, liver, and renal. In this case, we found reduced heart, liver, and renal function, requiring a multidisciplinary approach to improve the condition.