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non cirrhotic portal hypertension

Dale M Kobrin, Ana Luisa Pinto, Sophia T Parente, Marilia Gomes, Maria Augusta Cipriano, Maria Leticia Ribeiro, David C Fajgenbaum
No abstract text is available yet for this article.
February 15, 2019: Acta Oncologica
Beom Hee Kim, Jung Wha Chung, Chung Seop Lee, Eun Sun Jang, Sook-Hyang Jeong, Nayoung Kim, Jin-Wook Kim
Background/Aims: Non-selective β-blockers (NSBBs) are used for primary prevention of esophageal variceal hemorrhage (VH) in patients with portal hypertension, but a significant number of patients develop VH while on NSBB therapy. In this study, we sought to determine whether liver volume can predict the risk of primary prophylaxis failure in cirrhotic patients on NSBB therapy. Methods: A retrospective cohort of 309 patients on prophylactic propranolol was analyzed...
February 18, 2019: Korean Journal of Internal Medicine
Chiara Sartor, Laura Bachelot, Cécile Godard, Franck Lager, Gilles Renault, Frank J Gonzalez, Christine Perret, Angélique Gougelet, Sabine Colnot
BACKGROUND/AIMS: Loss of hepatocyte nuclear factor-4α (HNF4α), a critical factor driving liver development and differentiation, is frequently associated with hepatocellular carcinoma (HCC). Our recent data revealed that HNF4α level was decreased in mouse and human HCCs with activated β-catenin signaling. In addition, increasing HNF4α level by miR-34a inhibition slowed tumor progression of β-catenin activated HCC in mice. METHODS: We generated a Hnf4aflox/flox/ Apcflox/flox /TTR-CreERT 2 (Hnf4a/Apc∆Hep ) mouse line and evaluated the impact of Hnf4a disruption on HCC development and liver homeostasis...
February 5, 2019: Liver International: Official Journal of the International Association for the Study of the Liver
Federico Piñero, Manuel Mendizabal, Ezequiel Ridruejo, Fernando Herz Wolff, Beatriz Ameigeiras, Margarita Anders, María Isabel Schinoni, Virginia Reggiardo, Ana Palazzo, María Videla, Cristina Alonso, Luisa Santos, Adriana Varón, Sebastián Figueroa, Cecilia Vistarini, Raúl Adrover, Nora Fernández, Daniela Perez, Federico Tanno, Nelia Hernández, Marcela Sixto, Silvia Borzi, Andres Bruno, Daniel Cocozzella, Alejandro Soza, Valeria Descalzi, Claudio Estepo, Alina Zerega, Alexandre de Araujo, Hugo Cheinquer, Marcelo Silva
BACKGROUND & AIMS: Data from Europe and North America have been published regarding the risk of developing hepatocellular carcinoma (HCC) after treatment with direct antiviral agents (DAA). We proposed to evaluate cumulative incidence and associated risk factors for de novo HCC. METHODS: This was a prospective multicenter cohort study from Latin America including 1,400 F1-F4 treated patients with DAAs (F3-F4 n=1017). Cox proportional regression models (hazard ratios, HR and 95% CI) were used to evaluate independent associated variables with HCC...
January 13, 2019: Liver International: Official Journal of the International Association for the Study of the Liver
Bu-Shan Xie, Jia-Wei Zhong, An-Jiang Wang, Zhen-Dong Zhang, Xuan Zhu, Gui-Hai Guo
BACKGROUND: Duodenal varices are a lesser-known complication with non-cirrhotic portal hypertension. We report a circuitous route from missed diagnosis of duodenal varices to correction. An extremely rare case of duodenal variceal bleeding secondary to idiopathic portal hypertension (IPH) is expounded in this study, which was controlled by transjugular intra-hepatic porto-systemic shunt (TIPS) plus embolization. CASE SUMMARY: A 46-year-old woman with anemia for two years was frequently admitted to the local hospital...
December 26, 2018: World Journal of Clinical Cases
Ahmed Adel Amin, Eman Ibrahim Alabsawy, Rajiv Jalan, Andrew Davenport
Acute kidney injury (AKI) is a common presentation in patients with advanced cirrhosis hospitalized with acute decompensation. A new revised classification now divides AKI in cirrhotic patients into two broad subgroups: hepatorenal syndrome AKI (HRS AKI) and non-hepatorenal syndrome AKI (non-HRS AKI). HRS AKI represents the end-stage complication of decompensated cirrhosis with severe portal hypertension and is characterized by worsening of renal function in the absence of prerenal azotemia, nephrotoxicity, and intrinsic renal disease...
January 2019: Seminars in Nephrology
Mattia Crespi, Maria Giulia Demarzo, Matteo Brunacci, Gaia Pellegatta, Fabio Ferrando, Alberto Ballestrero, Federica Grillo, Vincenzo Savarino, Edoardo G Giannini
Chronic hepatitis C (HCV) virus infection may be associated with several non-hepatic manifestations, mainly driven by chronic immune stimulation, such as mixed cryoglobulinemia and Non-Hodgkin's Lymphoma. This association has been proved by several meta-analyses and some interventional studies demonstrating that antiviral treatment may be effective in inducing HCV-associated lymphoma regression. The recent advent of direct acting antivirals (DAAs) in the therapeutic armamentarium of HCV infection made possible treatment of patients with advanced liver disease...
October 16, 2018: Annals of Hepatology
Michel Bergère, Domitille Erard-Poinsot, Olivier Boillot, Pierre-Jean Valette, Olivier Guillaud, Christine Chambon-Augoyard, Jérôme Dumortier
BACKGROUND AND AIMS: Portal vein thrombosis (PVT) is a common complication of liver cirrhosis. Anticoagulation therapy is efficient, but is associated with potentially severe side-effects, especially bleeding episodes. It is therefore still unclear which patients will benefit from anticoagulation, and for what duration. The aim of the present study was to retrospectively analyse our single centre experience on long-term anticoagulation in patients presenting a PVT, complicating cirrhosis...
December 18, 2018: Clinics and Research in Hepatology and Gastroenterology
Junji Saruwatari, Chao Dong, Teruo Utsumi, Masatake Tanaka, Matthew McConnell, Yasuko Iwakiri
The spleen plays an important role in the immune and hematopoietic systems. Splenomegaly is a frequent consequence of portal hypertension, but the underlying molecular and cellular mechanisms remain to be fully elucidated. In this study, we have performed a whole-genome microarray analysis combined with histological examination in enlarged spleens isolated from rats with partial portal vein ligation (PPVL) surgery to provide comprehensive profiles of microRNAs and their target mRNAs with a focus on their potential biological functions...
December 20, 2018: Scientific Reports
Lubna Kamani, Baseer Sultan Ahmad, Muhammad Arshad, Pervez Ashraf
Objective: To determine the safety and efficacy of N-butyl 2-cyanoacrylate in bleeding gastric varices in children. Methods: This retrospective observational study was conducted in the Department of Gastroenterology and Pediatric Surgery in Liaquat National Hospital Karachi between January 2010 and January 2017. Gastric fundal varices were obliterated in pediatric population with single shot of N-butyl-2 Cyanoacrylate 0.50ml diluted with 0.50ml of Lipoidal with use of forward-viewing video endoscope with 22-gauge needle...
November 2018: Pakistan Journal of Medical Sciences Quarterly
F H Pals, H J Verkade, V A M Gulmans, B A E De Koning, B G P Koot, T G J De Meij, D M Hendriks, N Gierenz, A C E Vreugdenhil, R H J Houwen, F A J A Bodewes
BACKGROUND: Up to 10% of patients with Cystic Fibrosis develop cirrhotic CF-related liver disease with portal hypertension: CF cirrhosis (CFC). In a nationwide study, we aimed to determine the role of CFC on survival in the Netherlands between 1 and 1-2009 and1-1-2015. METHODS: We identified all CFC patients in the Netherlands, based on ultrasonographic liver nodularity and portal hypertension. A non-cirrhotic control group was obtained from the national Dutch CF patient registry...
December 14, 2018: Journal of Cystic Fibrosis: Official Journal of the European Cystic Fibrosis Society
Thomas Reiberger, Theresa Bucsics, Rafael Paternostro, Nikolaus Pfisterer, Florian Riedl, Mattias Mandorfer
Purpose of Review: The natural history and classification systems of small varices (≤ 5 mm in diameter) in cirrhotic patients with portal hypertension are summarized. Studies that assessed the course of and therapeutic intervention for small varices are discussed. Recent Findings: Current non-invasive methods show suboptimal sensitivity to detect small varices in patients with cirrhosis. Next to etiological therapy, hepatic venous pressure gradient (HVPG)-guided non-selective betablocker or carvedilol treatment has shown to impact on natural history of small varices...
2018: Current Hepatology Reports
A Marot, J V Barbosa, R Duran, P Deltenre, A Denys
PURPOSE: The purpose of this study was to evaluate the feasibility, safety, and efficacy of portal vein recanalization (PVR) and propose a new classification for better selecting candidates with portal vein occlusion (PVO) in whom PVR could be feasible. MATERIALS AND METHODS: The charts of 15 non-cirrhotic patients in whom stent placement using a trans-hepatic approach was attempted for the treatment of PVO with cavernous transformation were reviewed. There were 12 men and 5 women with a mean age of 47±12 years (range: 22-60 years)...
November 28, 2018: Diagnostic and Interventional Imaging
D Bhattacharjee, S Vracar, R A Round, P G Nightingale, J A Williams, G V Gkoutos, I M Stratton, R Parker, S D Luzio, G A Roberts, J Webber, S Ghosh, S E Manley
AIMS: To investigate the relationship between HbA1c and glucose in people with co-existing liver disease and diabetes awaiting transplant, and in those with diabetes but no liver disease. METHODS: HbA1c and random plasma glucose data were collected for 125 people with diabetes without liver disease and for 29 people awaiting liver transplant with diabetes and cirrhosis. The median (interquartile range) Model for End Stage Liver Disease score for the study cohort was calculated as 12 (9-17; normal <6)...
November 26, 2018: Diabetic Medicine: a Journal of the British Diabetic Association
Dou-Sheng Bai, Wen-Yu Shao, Chi Zhang, Ping Chen, Sheng-Jie Jin, Guo-Qing Jiang
BACKGROUND/AIMS: Splenectomy is regarded as an effective curative treatment for thrombocytopenia caused by hypersplenism in patients with cirrhosis. However, in clinical practice, thrombocytopenia is not resolved by splenectomy in all patients. This study aimed to evaluate the adverse factors responsible for platelet (PLT) counts below the normal lower limit following laparoscopic splenectomy and azygoportal disconnection (LSD). MATERIALS AND METHODS: We retrospectively evaluated the outcomes of 123 cirrhotic patients with portal hypertensive bleeding and secondary hypersplenism, who underwent LSD and who had PLT counts <125×109/L (non-normal group) or ≥125×109/L (normal group) at the postoperative month (POM) 3, between April 2014 and March 2017...
November 20, 2018: Turkish Journal of Gastroenterology: the Official Journal of Turkish Society of Gastroenterology
Maria Rosa Bella, Meritxell Casas, Mercedes Vergara, Enric Brullet, Félix Junquera, Eva Martínez-Bauer, Mireia Miquel, Jordi Sánchez-Delgado, Blai Dalmau, Rafael Campo, Xavier Calvet
INTRODUCTION: Upper gastroscopy in patients with cirrhosis often reveals non-specific lesions, which are usually oriented as portal hypertensive gastropathy (PHG). However, the diagnosis of PHG can be difficult, both from an endoscopic and histological point of view. The study of CD34 expression, which enhances the endothelial cells of the microvasculature, could help the differential diagnosis. The objectives of this study were to evaluate the correlation between endoscopy and histology in the diagnosis of PHG and to assess the utility of CD34 in the diagnosis of PHG...
November 17, 2018: Gastroenterología y Hepatología
Driss Raissi, Elizabeth A Roney, Mohamed M Issa, Sreeja Sanampudi, Michael A Winkler
Transjugular intrahepatic portosystemic shunt (TIPS) periprocedural thrombosis rates have fallen significantly since the introduction of polytetrafluoroethylene-covered stent grafts. We present a case of a cirrhotic patient with portal hypertension presenting with early TIPS thrombosis in association with an underlying competing spontaneous left mesenterico-gonadal venous shunt, an uncommon variant of spontaneous portal systemic shunt (SPSS). The patient presented with bleeding distal duodenal varices refractory to endovascular therapy, and although a successful TIPS procedure was performed for this indication, early thrombosis was determined by follow-up abdominopelvic computed tomographic angiography (CTA) scan...
October 27, 2018: Clinical Imaging
J G Abraldes, J Trebicka, N Chalasani, G D'Amico, D Rockey, V Shah, J Bosch, G Garcia-Tsao
Portal hypertension is the main driver of cirrhosis decompensation, the main determinant of death in patients with cirrhosis. Portal hypertension results initially from increased intrahepatic vascular resistance. Later, increased inflow from splanchnic vasodilation and increased cardiac output lead to a further increase in portal pressure. Reducing portal pressure in cirrhosis results in better outcomes. Removing the cause of cirrhosis might improve portal pressure. However, this is a slow process and patients may continue to be at risk of decompensation...
October 15, 2018: Hepatology: Official Journal of the American Association for the Study of Liver Diseases
Peter Lykke Eriksen, Anne Luise Hartkopf-Mikkelsen, Peter Ott, Hendrik Vilstrup, Niels Kristian Aagaard
Background: Terlipressin is used as pharmacological treatment for variceal bleeding. The drug's physiological effect favours hyponatremia, and rapid changes in plasma sodium (PNa) may cause brain injury. Cirrhosis patients seem to be largely protected against this effect but patients without cirrhosis may not be so. Objective: The objective of this study was to examine whether terlipressin treatment of patients without cirrhosis leads to more serious fluctuations in PNa than in cirrhosis...
October 2018: United European Gastroenterology Journal
Tilman Sauerbruch, Florence Wong
BACKGROUND: The development of cirrhosis with resultant portal hypertension can lead to oesophageal varices at a rate of 7% per annum. Bleeding from varices happens when the portal pressure is ≥12 mm Hg and can threaten life. SUMMARY: Eliminating the aetiology of cirrhosis is a pivotal step to prevent the formation of varices. In patients with established varices, primary prophylaxis with non-selective beta blockers (NSBB) may slow down the progression of varices and prevent the first variceal bleed...
September 13, 2018: Digestion
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