Nodular regenerative hyperplasia of the liver: an important cause of portal hypertension in non-cirrhotic patients.
In our hospital over the last 10 years a diagnosis of nodular regenerative hyperplasia was made for 13 patients. Sixty-nine percent of these patients had portal hypertension, representing 27% of all our patients with portal hypertension and a non-cirrhotic liver. Nodular regenerative hyperplasia was the second most frequent cause of portal hypertension in patients without cirrhosis. To make the diagnosis, a reticulin staining of a surgical biopsy is most helpful. However, the characteristic derangement of the liver architecture on histology may still be overlooked. In this study a suggestive relation was found between malignant disease (multiple myeloma, chronic myelogenous leukaemia, Leydig cell tumour and Hodgkin's disease), the use of cytotoxic or immunosuppressive drugs and nodular regenerative hyperplasia. Furthermore, a high rate of symptomatic nodular regenerative hyperplasia was observed in patients following kidney transplantation. Liver function abnormalities developed in these patients after a period ranging from 8 months to 3 years of immunosuppressive- or chemotherapy. These liver function abnormalities were, however, usually mild. Since hepatic encephalopathy is not likely to develop in these patients with nodular regenerative hyperplasia a decompressive shunt operation is a good alternative approach, if not the treatment of choice, for the prevention of recurrent variceal haemorrhage.
Naber
A H
AH
Department of Medicine, University Hospital of Nijmegen, The Netherlands.
Van Haelst
U
U
Yap
S H
SH
D000293:Adolescent; D000328:Adult; D000368:Aged; D000970:Antineoplastic Agents / Q000009:adverse effects; D001706:Biopsy; D005260:Female; D006801:Humans; D006965:Hyperplasia / Q000150:complications / Q000175:diagnosis / Q000473:pathology; D006975:Hypertension, Portal / Q000175:diagnosis / Q000209:etiology* / Q000473:pathology; D007166:Immunosuppressive Agents / Q000009:adverse effects; D008099:Liver / Q000187:drug effects / Q000473:pathology; D008107:Liver Diseases / Q000150:complications* / Q000175:diagnosis / Q000473:pathology; D008297:Male; D008875:Middle Aged
D000970:Antineoplastic Agents; D007166:Immunosuppressive Agents