Document Detail

Role of hepatic vein catheterisation and transient elastography in the diagnosis of idiopathic portal hypertension.
MedLine Citation:
PMID:  22721839     Owner:  NLM     Status:  Publisher    
BACKGROUND: Idiopathic portal hypertension is a rare cause of portal hypertension, frequently misdiagnosed as cryptogenic cirrhosis. This study evaluates specific findings at hepatic vein catheterisation or liver stiffness in idiopathic portal hypertension. METHODS: 39 cases of idiopathic portal hypertension patients were retrospectively reviewed. Hepatic vein catheterisation and liver stiffness measurements were compared to matched patients with cirrhosis and portal hypertension, and non-cirrhotic portal vein thrombosis, included as controls. RESULTS: Hepatic vein-to-vein communications were found in 49% idiopathic portal hypertension patients precluding adequate hepatic venous pressure gradient measurements in 12. In the remaining 27 patients, mean hepatic venous pressure gradient (HVPG) was 7.1±3.1mmHg. Only 5 patients had HVPG≥10mmHg. HVPG was markedly lower than in cirrhosis (17±3mmHg, p<0.001). Mean liver stiffness in idiopathic portal hypertension was 8.4±3.3kPa; significantly higher than in non-cirrhotic portal vein thrombosis (6.4±2.2kPa, p=0.009), but lower than in cirrhosis (40.9±20.5kPa, p=0.005). Only 2 idiopathic portal hypertension patients had liver stiffness >13.6kPa. CONCLUSIONS: Patients with idiopathic portal hypertension frequently have hepatic vein-to-vein communications and, despite unequivocal signs of portal hypertension, HVPG and liver stiffness values much lower than the cut-off for clinical significant portal hypertension in cirrhosis. These findings oblige to formally rule-out idiopathic portal hypertension in the presence of signs of portal hypertension.
Susana Seijo; Enric Reverter; Rosa Miquel; Annalisa Berzigotti; Juan G Abraldes; Jaume Bosch; Juan Carlos García-Pagán
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Publication Detail:
Type:  JOURNAL ARTICLE     Date:  2012-6-19
Journal Detail:
Title:  Digestive and liver disease : official journal of the Italian Society of Gastroenterology and the Italian Association for the Study of the Liver     Volume:  -     ISSN:  1878-3562     ISO Abbreviation:  -     Publication Date:  2012 Jun 
Date Detail:
Created Date:  2012-6-22     Completed Date:  -     Revised Date:  -    
Medline Journal Info:
Nlm Unique ID:  100958385     Medline TA:  Dig Liver Dis     Country:  -    
Other Details:
Languages:  ENG     Pagination:  -     Citation Subset:  -    
Copyright Information:
Copyright © 2012 Editrice Gastroenterologica Italiana S.r.l. Published by Elsevier Ltd. All rights reserved.
Hepatic Hemodynamic Laboratory, Liver Unit, Hospital Clínic, Institut d'Investigacions Biomèdiques August Pi i Sunyer (IDIBAPS), University of Barcelona, Spain.
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