Study of portal vein thrombosis in patients with idiopathic portal hypertension in Japan

Matsutani, Shoichi; Maruyama, Hitoshi; Akiike, Taro; Kobayashi, Satoshi; Yoshizumi, Hiroaki; Okugawa, Hidehiro; Fukuzawa, Takeshi; Kimura, Kazuhiro; Saisho, Hiromitsu

doi:10.1111/j.1478-3231.2005.01151.x

Cited by 49 publications

(33 citation statements)

References 22 publications

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“…Finally, a total of 69 well-characterized patients with IPH were included. Mean duration of follow-up from diagnosis was 6.7 6 4.6 years (median, 6; range, [1][2][3][4][5][6][7][8][9][10][11][12][13][14][15][16][17][18].…”

Section: Resultsmentioning

confidence: 99%

“…2,3,8,10,11 However, until now predictive factors of the development of PVT have never been evaluated. Our study clearly shows that HIV infection and VB at diagnosis of IPH are factors strongly associated with a higher risk of PVT.…”

Section: Discussionmentioning

confidence: 99%

“…Concerning PVT, data on its prevalence vary widely between studies. 2,3,8,10,11 Moreover, the efficacy of anticoagulant treatment in IPH patients with PVT has never been documented.…”

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confidence: 99%

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Idiopathic portal hypertension: Natural history and long-term outcome

et al. 2014

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Idiopathic portal hypertension (IPH) is a rare cause of intrahepatic portal hypertension. Data on natural history and prognosis of IPH are limited. We sought to describe the complications and long-tem outcome of IPH by retrospectively studying 69 biopsyproven cases of IPH. Mean duration of follow-up was 6.7 6 4.6 years. All patients had evidence of portal hypertension (PH) at diagnosis, and 42% were symptomatic. Variceal bleeding (VB) was the most common manifestation. In those without bleeding at diagnosis, 74% had varices at first endoscopy. In those with large varices, the 1-year probability of first bleeding despite primary prophylaxis was 9%. The 1-year probability of rebleeding was 22%. Ascites and hepatic encephalopathy was documented in 26% and 7% of patients, respectively, at least once during the clinical course. The 1-year probability of developing portal vein thrombosis (PVT) was 9%, and 53% of patients receiving anticoagulation achieved recanalization. Human immunodeficiency virus (HIV) infection and VB at diagnosis were the independent predictors of PVT. Seven patients died (6 as a result of an IPH-related cause) and 2 were transplanted. Probability of liver transplantation-free survival was 82% at 10 years. Presence of a severe associated disorder and ascites as a presenting symptom were associated with poor survival. Conclusion: Variceal bleeding is a major complication of IPH. Using, in IPH patients, the same management approach for PH as in cirrhosis is safe and maintains a low incidence of first bleeding and rebleeding in IPH patients. PVT is a frequent complication, particularly in those with HIV infection. Despite several complications, overall survival of patients with IPH is considerably good. (HEPATOLOGY 2014;59:2276-2285

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Section: Resultsmentioning

confidence: 99%

Section: Discussionmentioning

confidence: 99%

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Idiopathic portal hypertension: Natural history and long-term outcome

et al. 2014

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“…Secondly, there are studies that suggest thrombosis of the portal vein occurs during the course of IPH. In 2005, Matsutani et al [17] showed that 2 of 22 IPH patients had partial portal vein thrombosis at the time of IPH diagnosis, and another 7 patients (who were free of thrombosis at the time of IPH diagnosis) developed portal vein thrombosis in a mean period of 10.5 years. The authors believe that frequent follow up ultrasonography screening may be helpful in identifying thrombosis attacks.…”

Section: Thrombosis Theorymentioning

confidence: 99%

Clinical characteristics of idiopathic portal hypertension

Harmancı

Bayraktar²

2007

WJG

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Idiopathic portal hypertension is one of the interesting causes of portal hypertension. Even in very developed medical centers, this disorder is still one of the most important misdiagnoses of clinical practice. To inexperienced physicians, presenting esophageal varices and upper gastrointestinal bleeding usually prompt an unfortunate diagnosis of cirrhosis. A heterogenous clinical presentation and progression of this disorder should be recognized by physicians, and management should be directed towards some specific problems confined to this disorder. Although a genetic basis and other factors are implicated in its pathogenesis, exact underlying mechanism(s) is (are) unknown. In this review, we discuss the heterogeneity of idiopathic portal hypertension, its etiopathogenesis, clinical presentation and management issues. With the expectation of an excellent prognosis, a practicing gastroenterologist should be aware that "not all varices mean cirrhosis".

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“…39 Major presenting symptoms in Japanese patients with IPH seem to be splenomegaly (88%), hepatomegaly (44%), gastrointestinal bleeding (35%), and ascites (12%). 40 …”

Section: Clinical Featuresmentioning

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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Study of portal vein thrombosis in patients with idiopathic portal hypertension in Japan

Abstract: In Japan, IPH patients had a high incidence of portal thrombosis, a significant factor for poor prognosis. Whether the management of PVT contributes to an improvement of a clinical course of IPH or not should be clarified in further study.

Cited by 49 publications

References 22 publications

Idiopathic portal hypertension: Natural history and long-term outcome

Idiopathic portal hypertension: Natural history and long-term outcome

Clinical characteristics of idiopathic portal hypertension

Noncirrhotic Portal Hypertension

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