| Role of hepatic vein catheterisation and transient elastography in the diagnosis of idiopathic portal hypertension. | |
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MedLine Citation:
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PMID: 22721839 Owner: NLM Status: Publisher |
Abstract/OtherAbstract:
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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. |
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Authors:
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Susana Seijo; Enric Reverter; Rosa Miquel; Annalisa Berzigotti; Juan G Abraldes; Jaume Bosch; Juan Carlos García-Pagán |
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Publication Detail:
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Type: JOURNAL ARTICLE Date: 2012-6-19 |
Journal Detail:
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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:
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Created Date: 2012-6-22 Completed Date: - Revised Date: - |
Medline Journal Info:
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Nlm Unique ID: 100958385 Medline TA: Dig Liver Dis Country: - |
Other Details:
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Languages: ENG Pagination: - Citation Subset: - |
Copyright Information:
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Copyright © 2012 Editrice Gastroenterologica Italiana S.r.l. Published by Elsevier Ltd. All rights reserved. |
Affiliation:
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Hepatic Hemodynamic Laboratory, Liver Unit, Hospital Clínic, Institut d'Investigacions Biomèdiques August Pi i Sunyer (IDIBAPS), University of Barcelona, Spain. |
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From MEDLINE®/PubMed®, a database of the U.S. National Library of Medicine
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