Portal hypertension secondary to myelofibrosis with myeloid metaplasia: a study of 13 cases.
OBJECTIVE
To describe the clinical presentation and complications of portal hypertension (PH) secondary to myelofibrosis with myeloid metaplasia (MMM).


METHODS
Medical records for 123 patients with MMM were reviewed.


RESULTS
Thirteen patients with PH secondary to MMM were identified. Median ages at time of MMM and PH diagnosis were 61 and 66 years, respectively. The interval from MMM diagnosis to presentation with one of the PH features ranged from 1 to 11 years. Variceal bleeding and ascites were the most common presentations. Of the eight patients who presented with variceal bleeding, six patients underwent endoscopic variceal ligation (EVL) with no variceal recurrence or hematological worsening during a 12-mo follow up period.


CONCLUSIONS
Patients with MMM might develop PH. Exact mechanisms leading to PH in MMM are still controversial. As in other etiologies, variceal bleeding and ascites are the most common presentations. Anemia may correlate with, and/or predict, the severity of the PH presentation in these patients. EVL can successfully control variceal bleeding in MMM. Further clinical studies are required.
Abu-Hilal
Mohannad
M
Department of Internal Medicine, Division of Gastroenterology, Mayo Clinic College of Medicine, Rochester, MN 55902, USA. abuhilal.mohannad@yahoo.com
Tawaker
Jayant
J
D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D003937:Diagnosis, Differential; D006801:Humans; D006975:Hypertension, Portal / Q000209:etiology* / Q000473:pathology / Q000503:physiopathology; D008875:Middle Aged; D055728:Primary Myelofibrosis / Q000150:complications* / Q000473:pathology / Q000503:physiopathology