Document Detail


Obliterative portal venopathy: portal hypertension is not always present at diagnosis.
MedLine Citation:
PMID:  21087805     Owner:  NLM     Status:  MEDLINE    
Abstract/OtherAbstract:
BACKGROUND & AIMS: Previous studies on obliterative portal venopathy (OPV) have been biased due to the selection of patients with non-cirrhotic portal hypertension. The aim of this study was to clarify the characteristics of OVP diagnosed by liver biopsy.
METHODS: Fifty-nine consecutive patients with OPV were retrospectively selected on strict histological criteria. Clinical, laboratory, portal vein patency, and associated disorders potentially involving vascular alterations were analyzed. The occurrence of complications was recorded during follow-up.
RESULTS: Mean age at diagnosis was 38.5±15 years old. Initial presentation was portal hypertension (64% of patients) and/or extrahepatic portal vein thrombosis (EHPVT) (22%) or isolated abnormal laboratory tests (20%). Associated diseases found at diagnosis were: prothrombotic disorders (30% of patients) and immune-mediated disorders (17%); 53% of patients had no causal factor (idiopathic OPV). During follow-up (median 8.6 years, range 1-23 years), features of portal hypertension worsened in 46% of patients; EHPVT and portal hypertension were finally found in 44% and 88% of patients. Anti-coagulation and beta-blockers were administered in 47% and 59% of patients, respectively. Severe complications (liver transplantation and/or death) occurred in 11 (19%) patients, 8 had idiopathic OPV. Patients with prothrombotic disorders received earlier anticoagulation therapy; all survived without transplantation.
CONCLUSIONS: A confident diagnosis of OPV can be done by biopsy and is conceivable in patients under 40 years without clinically significant portal hypertension. Poor outcome was noted in 19% of patients, most of them affected with idiopathic OPV. Patients with prothrombotic disorders received early anticoagulation and appeared to have a better outcome despite a high proportion of EHPVT.
Authors:
Dominique Cazals-Hatem; Sophie Hillaire; Marika Rudler; Aurélie Plessier; Valerie Paradis; Bertrand Condat; Claire Francoz; Marie-Hélène Denninger; François Durand; Pierre Bedossa; Dominique C Valla
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Publication Detail:
Type:  Journal Article     Date:  2010-10-28
Journal Detail:
Title:  Journal of hepatology     Volume:  54     ISSN:  1600-0641     ISO Abbreviation:  J. Hepatol.     Publication Date:  2011 Mar 
Date Detail:
Created Date:  2011-02-18     Completed Date:  2011-06-21     Revised Date:  2012-08-24    
Medline Journal Info:
Nlm Unique ID:  8503886     Medline TA:  J Hepatol     Country:  England    
Other Details:
Languages:  eng     Pagination:  455-61     Citation Subset:  IM    
Copyright Information:
Copyright © 2010 European Association for the Study of the Liver. Published by Elsevier B.V. All rights reserved.
Affiliation:
Service d'Anatomie-Pathologique, Hôpital Beaujon AP-HP, Clichy and Institut National de la Santé et de la Recherche Médicale U773, Centre de Recherche Biomédicale Bichat Beaujon CRB3, Université Denis Diderot-Paris 7, France. dominique.cazals-hatem@bjn.aphp.fr
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MeSH Terms
Descriptor/Qualifier:
Adolescent
Adult
Aged
Biopsy, Needle
Child
Cohort Studies
Female
Humans
Hypertension, Portal / diagnosis*,  therapy
Liver / blood supply,  pathology
Male
Middle Aged
Portal Vein* / pathology
Prognosis
Retrospective Studies
Vascular Diseases / diagnosis*,  pathology,  therapy
Venous Thrombosis / diagnosis,  therapy
Young Adult

From MEDLINE®/PubMed®, a database of the U.S. National Library of Medicine


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