Risk factors and outcome of HIV-associated idiopathic noncirrhotic portal hypertension

2012 ◽  
Vol 36 (9) ◽  
pp. 875-885 ◽  
Author(s):  
J. N. L. Schouten ◽  
M. E. Van der Ende ◽  
T. Koëter ◽  
H. H. M. Rossing ◽  
M. Komuta ◽  
...  
Keyword(s):  
Risk Factors ◽  
Portal Hypertension ◽  
Noncirrhotic Portal Hypertension

A young man with bleeding esophageal varices

2018 ◽  
Vol 1 (1) ◽  
pp. 14-16
Author(s):  
Soonthorn Chonprasertsuk
Keyword(s):  
Risk Factors ◽  
Portal Hypertension ◽  
Liver Function ◽  
Physical Examination ◽  
Esophageal Varices ◽  
Noncirrhotic Portal Hypertension ◽  
Liver Histopathology ◽  
Bleeding Esophageal Varices

The noncirrhotic portal hypertension is an uncommon cause of bleeding esophagealvarices. This condition must be suspected in patients with preserved liver function. We reporta 25-year old man with SLE disease who presented with hematemesis. He had no historyor risk factors for an underlying liver condition. A huge splenomegaly was detectedby physical examination. The EGD found three large varices with red wale sign, whereas liverfunction tests were unremarkable. The noncirrhotic portal hypertension was diagnosedand confirmed by liver histopathology. Figure 1 แสดงผลการส่องกล้องทางเดินอาหารส่วนบนพบ F3 varices with red wale sign

A young man with bleeding esophageal varices

2018 ◽  
Vol 1 (1) ◽  
pp. 14-16
Author(s):  
Soonthorn Chonprasertsuk
Keyword(s):  
Risk Factors ◽  
Portal Hypertension ◽  
Liver Function ◽  
Physical Examination ◽  
Esophageal Varices ◽  
Liver Function Tests ◽  
Noncirrhotic Portal Hypertension ◽  
Liver Histopathology ◽  
Function Tests ◽  
Bleeding Esophageal Varices

The noncirrhotic portal hypertension is an uncommon cause of bleeding esophageal varices. This condition must be suspected in patients with preserved liver function. We report a 25-year old man with SLE disease who presented with hematemesis. He had no history or risk factors for an underlying liver condition. A huge splenomegaly was detected by physical examination. The EGD found three large varices with red wale sign, whereas liver function tests were unremarkable. The noncirrhotic portal hypertension was diagnosed and confirmed by liver histopathology.

A young man with bleeding esophageal varices

2018 ◽  
Vol 1 (1) ◽  
pp. 14-16
Author(s):  
Soonthorn Chonprasertsuk
Keyword(s):  
Risk Factors ◽  
Portal Hypertension ◽  
Liver Function ◽  
Physical Examination ◽  
Esophageal Varices ◽  
Liver Function Tests ◽  
Noncirrhotic Portal Hypertension ◽  
Liver Histopathology ◽  
Function Tests ◽  
Bleeding Esophageal Varices

The noncirrhotic portal hypertension is an uncommon cause of bleeding esophageal varices. This condition must be suspected in patients with preserved liver function. We report a 25-year old man with SLE disease who presented with hematemesis. He had no history or risk factors for an underlying liver condition. A huge splenomegaly was detected by physical examination. The EGD found three large varices with red wale sign, whereas liver function tests were unremarkable. The noncirrhotic portal hypertension was diagnosed and confirmed by liver histopathology. Figure 1 แสดงผลการส่องกล้องทางเดินอาหารส่วนบน พบ F3 varices with red wale sign

Risk Factors for Hepatic Encephalopathy after Transjugular Intrahepatic Portosystemic Shunt in Patients with Hepatocellular Carcinoma and Portal Hypertension

2015 ◽  
Vol 24 (3) ◽  
pp. 301-307 ◽  
Author(s):  
Jiannan Yao ◽  
Li Zuo ◽  
Guangyu An ◽  
Zhendong Yue ◽  
Hongwei Zhao ◽  
...  
Keyword(s):  
Risk Factors ◽  
Hepatocellular Carcinoma ◽  
Portal Hypertension ◽  
Hepatic Encephalopathy ◽  
Pressure Gradient ◽  
Transjugular Intrahepatic Portosystemic Shunt ◽  
Meld Score ◽  
Portosystemic Shunt ◽  
Portal Flow ◽  
Intrahepatic Portosystemic Shunt

Aims: This study aimed at assessing the risk factors for hepatic encephalopathy (HE) after transjugular intrahepatic portosystemic shunt (TIPS) in patients with hepatocellular carcinoma (HCC) and portal hypertension. Method: Consecutive patients (n=279) with primary HCC who underwent TIPS between January 1997 and March 2012 at a single institution were retrospectively reviewed. Patients were followed up for 2 years. Pre-TIPS, peri-TIPS and post-TIPS clinical variables were reviewed using univariate and multivariate analyses to identify risk factors for HE after TIPS. Results: The overall incidence of HE was 41% (114/279). Multivariate analysis showed an increased odds for HE in patients with: >3 treatments with transcatheter arterial chemoembolization (TACE) and/or trans-arterial embolization (TAE) (odds ratio [OR], 4.078; 95% confidence interval [95%CI], 1.748-9.515); hepatopetal portal flow (OR, 2.362; 95%CI, 1.032-5.404); high portosystemic pressure gradient (OR, 1.198; 95%CI, 1.073-1.336) and high pre-TIPS MELD score (OR, 1.693; 95%CI, 1.390-2.062). Odds for HE were increased 1.693 fold for each 1-point increase in the MELD score, and 1.198 fold for each 1-mmHg decrease in the post-TIPS portosystemic pressure gradient. Conclusion: The identification of clinical variables associated with increased odds of HE may be useful for the selection of appropriate candidates for TIPS. Results suggest that an inappropriate decrease in the portosystemic pressure gradient might be associated with HE after TIPS. In addition, >3 treatments with TACE/TAE, hepatopetal portal flow, and high MELD score were also associated with increased odds of HE after TIPS. Key words:  –  –  – .

scholarly journals Hematological Indices in Portal Hypertension: Cirrhosis versus Noncirrhotic Portal Hypertension

2018 ◽  
Vol 7 (8) ◽  
pp. 196 ◽  
Author(s):  
Abdurrahman Sahin ◽  
Hakan Artas ◽  
Nurettin Tunc ◽  
Mehmet Yalniz ◽  
Ibrahim Bahcecioglu
Keyword(s):  
Portal Hypertension ◽  
Retrospective Study ◽  
Radiological Findings ◽  
Hematological Indices ◽  
Noncirrhotic Portal Hypertension ◽  
End Stage Liver Disease ◽  
Cirrhotic Patients ◽  
Hematological Abnormalities ◽  
End Stage ◽  
Cirrhotic Group

Portal hypertension (PHT) leads to several alterations on hematological indices (HI). The aim of the study is to investigate the differences in HI between cirrhotic subjects and subjects who have noncirrhotic PHT (NCPHT). This retrospective study included 328 patients with PHT (239 cirrhosis and 89 NCPHT). Demographic and clinical features, endoscopic and radiological findings, and HI including neutrophil to lymphocyte ratio (NLR) at the time of PHT diagnosis were recorded. Severity of cirrhosis was assessed according to the Child–Turcotte–Pugh (CTP) classification and Model for End-Stage Liver Disease (MELD) scores. Hematological abnormalities were found in 92.5% of cirrhotic patients and in 55.1% of patients with NCPHT (p < 0.001). While thrombocytopenia was the most common HI in patients with cirrhosis, anemia was the most prevalent HI in NCPHT group. In the cirrhotic group, the NLR was the only parameter to differentiate each CTP group from two others. The NLR value increased with the severity of cirrhosis (2.28 ± 0.14 in CTP-A, 2.85 ± 0.19 in CTP-B and 3.26 ± 0.37 in CTP-C). The AUROC of NLR was 0.692 for differentiating compensated cirrhotic patients from decompensated. Hematological abnormalities are more prevalent and more severe in cirrhotic patients compared to patients with NCPHT. NLR may be used to assess the severity of cirrhosis.

scholarly journals Splenomegaly and thrombocytopenia in patients with liver cirrhosis

2010 ◽  
Vol 67 (2) ◽  
pp. 166-169 ◽  
Author(s):  
Jelena Djordjevic ◽  
Petar Svorcan ◽  
Dusica Vrinic ◽  
Branka Dapcevic
Keyword(s):  
Risk Factors ◽  
Liver Cirrhosis ◽  
Platelet Count ◽  
Portal Hypertension ◽  
Hepatic Dysfunction ◽  
Spleen Size ◽  
Hepatitis Viruses ◽  
Decompensated Liver Cirrhosis ◽  
Splenic Sequestration ◽  
Frequent Finding

Backgroud/Aim. Splenomegaly is a frequent finding in patients with liver cirrhosis and portal hypertension and may cause hypersplenism. The occurrence of thrombocytopenia in those patients can be considered as an event with multiple etiologies. Two mechanisms may act alone or synergistically with splenic sequestration. One is central which involves either myelosuppression because of hepatitis viruses or the toxic effects of alcohol abuse on the bone marrow. The second one involves the presence of antibodies against platelets. It also depends upon the stage and etiology of liver disease. The aim of the study was to investigate a correlation between the platelet count and spleen size and the risk factors for thrombocytopenia in patients with liver cirrhosis. Methods. We studied 40 patients with decompensated liver cirrhosis who were hospitalized in the Department of Gastroenterohepatology. The liver function was graded according to Child Pugh score. Spleen size was defined ultrasonografically on the basis of craniocaudal length. Suspicion of portal hypertension was present when longitudinal spleen length was more than 11 cm. Thrombocytopenia was determined by platelet count under 150 000/mL. Results. We did not find any significant correlation between hepatic dysfunction and spleen size (p = 0.9), and between hepatic dysfunction and thrombocytopenia (p = 0.17). Our study did not find any significant correlation between spleen size and peripheral platelet count (p = 0.5), but we found a significant correlation between thrombocytopenia and etiology of cirrhosis - decreased platelet count was more common among patients with cirrhosis of alcoholic etiology than in other etiologies of cirrhosis (p = 0.001). Conclusion. According to our study, liver cirrhosis, portal hypertension and thrombocytopenia could be present even in the absence of enlarged spleen suggesting the involvement of other mechanisms of decreasing platelet account.

scholarly journals NONCIRRHOTIC PORTAL HYPERTENSION IN A PATIENT WITH JUVENILE SYSTEMIC LUPUS ERYTHEMATOSUS: A CASE REPORT

2021 ◽  
Author(s):  
Rafael Fusaro Aguiar Oliveira ◽  
Anna Carolina Faria Moreira Gomes Tavares ◽  
Lucas Moyses Carvalho de Oliveira ◽  
Matheus Fonseca Cardoso ◽  
Ana Paula Bernardes Real
Keyword(s):  
Systemic Lupus Erythematosus ◽  
Case Report ◽  
Portal Hypertension ◽  
Lupus Erythematosus ◽  
Systemic Lupus ◽  
Juvenile Systemic Lupus Erythematosus ◽  
Noncirrhotic Portal Hypertension
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