» Articles » PMID: 28597108

Prevalence of Histological Features of Idiopathic Noncirrhotic Portal Hypertension in General Population: a Retrospective Study of Incidental Liver Biopsies

Overview
Journal Hepatol Int
Publisher Springer
Specialty Gastroenterology
Date 2017 Jun 10
PMID 28597108
Citations 11
Authors
Affiliations
Soon will be listed here.
Abstract

Background: Idiopathic noncirrhotic portal hypertension (INCPH) is associated with histologic changes secondary to obliterative portal venopathy without cirrhosis. We studied the prevalence of individual histological features of INCPH in liver biopsies obtained incidentally during unrelated elective procedures and in elective liver biopsies with the diagnosis of fatty liver disease.

Methods: A total of 53 incidental liver biopsies obtained intraoperatively during unrelated elective procedures and an additional 28 elective biopsies with the diagnosis of fatty liver disease without portal hypertension and cirrhosis were studied. Various histologic features of INCPH were evaluated.

Results: Shunt vessel (30%), phlebosclerosis (27%), increased number of portal vessels (19%) and incomplete septa (17%) were common in these liver biopsies after confounding factors such as co-existing fatty liver disease or fibrosis were excluded. At least one feature of INCPH was noted in 90% of the biopsies. Eight (10%) biopsies showed 5-6 features of INCPH. In total, 11 (14%) of 81 patients had risk factors associated with INCPH, including hypercoagulability, autoimmune disease, exposure to drugs, and infections. No patient had portal hypertension at the end of the follow-up.

Conclusion: The histologic features of INCPH are seen in incidental liver biopsies and fatty liver disease without portal hypertension. Ten percent of the biopsies show 5-6 features of INCPH without portal hypertension. Interpreting histologic features in the right clinical context is important for proper patient care.

Citing Articles

Unexplained Chronically Elevated Aminotransferases: Liver Biopsy Gives Major Information with Therapeutic Implication in One Patient Out of Seven.

Pietri O, Chicaud M, Andreani T, Chretien Y, Limousin W, Lemoinne S Dig Dis Sci. 2024; .

PMID: 39681748 DOI: 10.1007/s10620-024-08730-0.


Evaluation of the histologic and immunohistochemical (CD34, glutamine synthetase) findings in idiopathic non-cirrhotic portal hypertension (INCPH).

Buyuk M, Berker N, Bakkaloglu D, Senkal I, Onal Z, Gulluoglu M Hepatol Int. 2024; 18(3):1011-1019.

PMID: 38536628 PMC: 11126445. DOI: 10.1007/s12072-024-10654-w.


Idiopathic Non-Cirrhotic Portal Hypertension and Porto-Sinusoidal Vascular Disease: Review of Current Data.

Kmeid M, Liu X, Ballentine S, Lee H Gastroenterology Res. 2021; 14(2):49-65.

PMID: 34007347 PMC: 8110235. DOI: 10.14740/gr1376.


Undiagnosed liver diseases.

Gao E, Hercun J, Heller T, Vilarinho S Transl Gastroenterol Hepatol. 2021; 6:28.

PMID: 33824932 PMC: 7829073. DOI: 10.21037/tgh.2020.04.04.


Interobserver study on histologic features of idiopathic non-cirrhotic portal hypertension.

Kmeid M, Zuo C, Lagana S, Choi W, Lin J, Yang Z Diagn Pathol. 2020; 15(1):129.

PMID: 33097074 PMC: 7583235. DOI: 10.1186/s13000-020-01049-0.


References
1.
Brunt E, Janney C, Di Bisceglie A, Neuschwander-Tetri B, Bacon B . Nonalcoholic steatohepatitis: a proposal for grading and staging the histological lesions. Am J Gastroenterol. 1999; 94(9):2467-74. DOI: 10.1111/j.1572-0241.1999.01377.x. View

2.
Wanless I . Micronodular transformation (nodular regenerative hyperplasia) of the liver: a report of 64 cases among 2,500 autopsies and a new classification of benign hepatocellular nodules. Hepatology. 1990; 11(5):787-97. DOI: 10.1002/hep.1840110512. View

3.
Lee H, Ainechi S, Dresser K, Kurian E . Central portalization correlates with fibrosis but not with risk factors for nonalcoholic steatohepatitis in steatotic chronic hepatitis C. Int J Hepatol. 2014; 2014:329297. PMC: 4265703. DOI: 10.1155/2014/329297. View

4.
Wanless I, Shiota K . The pathogenesis of nonalcoholic steatohepatitis and other fatty liver diseases: a four-step model including the role of lipid release and hepatic venular obstruction in the progression to cirrhosis. Semin Liver Dis. 2004; 24(1):99-106. DOI: 10.1055/s-2004-823104. View

5.
Sarin S, Kumar A, Chawla Y, Baijal S, Dhiman R, Jafri W . Noncirrhotic portal fibrosis/idiopathic portal hypertension: APASL recommendations for diagnosis and treatment. Hepatol Int. 2009; 1(3):398-413. PMC: 2716836. DOI: 10.1007/s12072-007-9010-9. View