title: Type C chronic hepatitis associated with thrombocytopenia in two patients.
abstract: Portal hypertension in the presence of chronic hepatitis is generally thought to develop during the progression of the chronic hepatitis to cirrhosis. Before the establishment of assays for diagnosing hepatitis C virus infection, such a case of portal hypertension without liver cirrhosis could be misdiagnosed as idiopathic portal hypertension. It had not fully determined whether portal hypertension might precede the onset of cirrhosis in type C chronic hepatitis. This report presents two cases of women with chronic hepatitis C who developed severe thrombocytopenia; each showed splenomegaly and hypersplenism due to portal hypertension. Angiographic study and histological analysis were conducted to determine the cause of the portal hypertension. Histological evaluation showed an intrahepatic presinusoidal block pattern and fibrotic changes in the periportal area, but no evidence of liver cirrhosis or of other incidental complications such as idiopathic portal hypertension. Both of these patients exhibited normal platelet counts after splenectomy. Thus, type C chronic hepatitis can lead to portal hypertension, as demonstrated in these two patients.
authors.affiliation: Second Department of Internal Medicine, Shinshu University School of Medicine, Matsumoto, Japan.
authors.forename: K
authors.initials: K
authors.lastname: Yabu
authors.forename: K
authors.initials: K
authors.lastname: Kiyosawa
authors.forename: S
authors.initials: S
authors.lastname: Ako
authors.forename: S
authors.initials: S
authors.lastname: Usuda
authors.forename: K
authors.initials: K
authors.lastname: Yoshizawa
authors.forename: E
authors.initials: E
authors.lastname: Tanaka
authors.forename: T
authors.initials: T
authors.lastname: Sodeyama
authors.forename: S
authors.initials: S
authors.lastname: Furuta
mesh_terms: D002908:Chronic Disease; D003937:Diagnosis, Differential; D005260:Female; D006503:Hepatic Veins / Q000000981:diagnostic imaging; D006526:Hepatitis C / Q000150:complications*; D006801:Humans; D006975:Hypertension, Portal / Q000150:complications / Q000175:diagnosis / Q000473:pathology; D008099:Liver / Q000473:pathology; D008875:Middle Aged; D013921:Thrombocytopenia / Q000150:complications*; D014057:Tomography, X-Ray Computed