Prevalence of histological features of idiopathic noncirrhotic portal hypertension in general population: a retrospective study of incidental liver biopsies

Zuo, Chunlai; Chumbalkar, Vaibhav; Ells, Peter; Bonville, Daniel J.; Lee, Hwajeong

doi:10.1007/s12072-017-9801-6

Cited by 32 publications

(34 citation statements)

References 28 publications

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“…We do not dispute the results of studies such as the Zuo et al report, which showed that histologic changes similar to those in INCPH can be observed in diseases other than INCPH [11]. However, it is not yet clear whether these similar pathologic changes found under INCPH and non-INCPH conditions are actually the same or not.…”

contrasting

confidence: 56%

“…On the other hand, histologic findings similar to those in INCPH have been reported in non-INCPH cases [11][12][13][14]. Zuo et al recently investigated fatty liver histopathologically and reported some interesting findings [11].…”

mentioning

confidence: 77%

“…It seems important to examine this question in more detail. For example, Zuo et al described thin-walled vessels present in the paraportal area as shunt vessels in their study [11], but it is unclear whether these have the same shunt function in fatty liver as they do in INCPH. This vascular change observed in fatty liver may not be a shunt but simply an expansion of the vasa septalis and inlet venule induced by another cause.…”

mentioning

confidence: 88%

“…They also reported aggravation of symptoms when portal hypertension was present. Careful long-term follow-up may be necessary to clarify whether cases of portal hypertension develop from the non-INCPH cases with fatty liver investigated by Zuo et al [11].…”

mentioning

confidence: 98%

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Pathology of idiopathic non-cirrhotic portal hypertension

Kage

2017

Hepatol Int

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contrasting

confidence: 56%

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confidence: 77%

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confidence: 88%

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confidence: 98%

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Pathology of idiopathic non-cirrhotic portal hypertension

Kage

2017

Hepatol Int

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“…The gross pathology of IPH can be subcapsular parenchymal atrophy and nodular and thrombosis of the portal vein branches . Portal fibrosis, incomplete septa, and nodular regenerative hyperplasia (NRH) are typical histopathological features, along with occlusion of small portal vein, thickening of the portal vein wall, shunt vessel herniation into the liver parenchyma, sinusoidal dilatation, and phlebosclerosis …”

Section: Introductionmentioning

confidence: 99%

Clinical features of idiopathic portal hypertension in China: A retrospective study of 338 patients and literature review

Sun

Shao

et al. 2018

J of Gastro and Hepatol

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Background and Aim Idiopathic portal hypertension (IPH) refers to a relatively rare condition characterized by intrahepatic portal hypertension in the absence of underlying disease such as liver cirrhosis. Methods We retrospectively reviewed 338 patients with IPH that were diagnosed at the pathological consultation center of our hospital. Results The ratio of male to female patients was 1:1. Mean age at onset was 35.1 ± 16.5 years; male patients on average were 12 years younger than female patients at onset. The median duration from onset to IPH diagnosis was 12 months. In 50 patients, medication use may have been an etiological factor. The most common clinical manifestations were splenomegaly (91.3%) and hypersplenism (68.9%); 57.0% patients presented varicosis, while 25.1% patients had a history of variceal bleeding. Nodular regenerative hyperplasia was found in 22.2% liver biopsies. Among patients for whom laboratory data were available, 65.0%, 50.3%, and 71.4% patients presented leukopenia, anemia, and thrombocytopenia due to hypersplenism. Liver function was mostly in the compensated stage. Female patients showed worse leukopenia and anemia, while male patients were more likely to have abnormal serum transaminase and bilirubin levels. Sixty‐seven patients received surgical or interventional treatment. Conclusions High‐quality liver biopsy, detailed clinical information, and expert pathologist are necessary for diagnosis of IPH. IPH can occur concurrently with other liver disease such as hepatitis and drug‐induced liver injury. Medication appears to be an important etiological factor for IPH in China. Management approach was largely focused on treatment of portal hypertension and its complications.

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