Nodular regenerative hyperplasia of the liver: an important cause of portal hypertension in non-cirrhotic patients

Naber, A.H.J.; Haelst, U. van; Yap, Sing Hiem

doi:10.1016/0168-8278(91)90916-y

Cited by 110 publications

(77 citation statements)

References 12 publications

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“…16 NRH often is combined with various systemic diseases or cytotoxic and immunosuppressive drug intake, which can induce thrombotic venopathy. [33][34][35][36][37] NRH now is considered a major cause of portal hypertension in young, noncirrhotic patients. 33,34 NRH lesions often are multiple and hyperechoic on US scans and hypodense with no significant enhancement and no central scar on CT scans.…”

Section: Discussionmentioning

confidence: 99%

“…[33][34][35][36][37] NRH now is considered a major cause of portal hypertension in young, noncirrhotic patients. 33,34 NRH lesions often are multiple and hyperechoic on US scans and hypodense with no significant enhancement and no central scar on CT scans. [32][33][34][35][36] Histologic examination usually is necessary to establish the diagnosis of NRH.…”

Section: Discussionmentioning

confidence: 99%

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Hepatic focal nodular hyperplasia in children previously treated for a solid tumor

Bouyn

Leclère

Raimondo

et al. 2003

Cancer

132

126

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BACKGROUNDThe detection of hepatic nodules, particularly in patients treated for a previous malignancy, raises a diagnostic dilemma. Focal nodular hyperplasia (FNH) of the liver is an uncommon, benign tumor in children and must be differentiated from malignant hepatic lesions. The etiology of FNH is obscure, and its pathogenesis is poorly understood. FNH may be a reaction to localized vascular abnormalities and circulatory disturbances. The goal of the current study was to identify risk factors for the occurrence of FNH in children who had received prior treatment for a malignant tumor.METHODSThe current retrospective study examined 14 cases of FNH in pediatric patients who previously had been treated for a malignancy. Diagnosis was based on clinical and radiologic findings and was proven histologically in four cases.RESULTSFNH lesions were discovered by chance during routine examination in 78% of patients. The incidence of FNH was particularly high in the current series (0.45%) compared with the incidence in the general pediatric population. High doses of alkylating agents (e.g., busulfan or melphalan), venoocclusive disease, and liver radiotherapy may be responsible for injury to the vascular endothelium and subsequent localized circulatory disturbances. FNH is characterized by the absence of complications after its detection; therefore, only close follow‐up is recommended.CONCLUSIONSFNH appears to be a late complication of an iatrogenic vascular disease in children with a history of malignancy. Cancer 2003;97:3107–13. © 2003 American Cancer Society.DOI 10.1002/cncr.11452

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Section: Discussionmentioning

confidence: 99%

Section: Discussionmentioning

confidence: 99%

Hepatic focal nodular hyperplasia in children previously treated for a solid tumor

Bouyn

Leclère

Raimondo

et al. 2003

Cancer

132

126

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“…While performing our study disturbing high frequencies of nodular regenerative hyperplasia (NRH) of the liver were reported in an IBD population treated with 6-TG by Dubinsky and collaegues: NRH occurred in 76% of patients undergoing biopsy after laboratory abnormalities [49,50]. NRH is a serious complication also associated with AZA and 6-MP and a frequent cause of portal hypertension [51,52]. Therefore we im-139 mediately performed an abdominal ultrasonography in the 54% of patients already using 6-TG for 1 year and discovered only one patient with signs of portal hypertension indicated by an enlarged spleen [48].…”

Section: -Thioguaninementioning

confidence: 79%

Thiopurines in inflammatory bowel disease: New strategies for optimization of pharmacotherapy?

Derijks

Hommes²

2006

Curr Gastroenterol Rep

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“…113 It is believed that nodular regenerative hyperplasia is a secondary and nonspecific tissue adaptation to heterogeneous distribution of blood flow and does not represent a specific entity. The exact pathogenesis of NRH is incompletely understood.…”

Section: Etiologymentioning

confidence: 99%

Noncirrhotic Portal Hypertension

Rajekar¹,

Vasishta²,

Chawla³

et al. 2011

Journal of Clinical and Experimental Hepatology

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Portal hypertension is characterized by an increase in portal pressure (> 10 mmHg) and could be a result of cirrhosis of the liver or of noncirrhotic diseases. When portal hypertension occurs in the absence of liver cirrhosis, noncirrhotic portal hypertension (NCPH) must be considered. The prognosis of this disease is much better than that of cirrhosis. Noncirrhotic diseases are the common cause of portal hypertension in developing countries, especially in Asia. NCPH is a heterogeneous group of diseases that is due to intrahepatic or extrahepatic etiologies. In general, the lesions in NCPH are vascular in nature and can be classified based on the site of resistance to blood flow. In most cases, these disorders can be explained

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Nodular regenerative hyperplasia of the liver: an important cause of portal hypertension in non-cirrhotic patients

Cited by 110 publications

References 12 publications

Hepatic focal nodular hyperplasia in children previously treated for a solid tumor

Hepatic focal nodular hyperplasia in children previously treated for a solid tumor

Thiopurines in inflammatory bowel disease: New strategies for optimization of pharmacotherapy?

Noncirrhotic Portal Hypertension

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