title: A study of aetiology of portal hypertension in adults (including the elderly) at a tertiary centre in southern India.
abstract: OBJECTIVE
  There are only a few studies on aetiology of portal hypertension among adults presenting to tertiary care centres in India; hence we conducted this study to assess the aetiological reasons for portal hypertension in adult patients attending a tertiary care centre in southern India.
  
  
  METHODS
  Causes of portal hypertension were studied in consecutive new adult patients with portal hypertension attending department of Hepatatology at a tertiary care centre in south India during July 2009 to July 2010.
  
  
  RESULTS
  A total of 583 adult patients (>18 yr old) were enrolled in the study. After non-invasive testing, commonest causes of portal hypertension were cryptogenic chronic liver disease (35%), chronic liver disease due to alcohol (29%), hepatitis B (17%) or hepatitis C (9%). Of the 203 patients with cryptogenic chronic liver disease, 39 had liver biopsy - amongst the latter, idiopathic non cirrhotic intrahepatic portal hypertension (NCIPH) was seen in 16 patients (41%), while five patients had cirrhosis due to non alcoholic fatty liver disease. Fifty six (10%) adult patients with portal hypertension had vascular liver disorders. Predominant causes of portal hypertension in elderly (>60 yrs; n=83) were cryptogenic chronic liver disease (54%) and alcohol related chronic liver disease (16%).
  
  
  CONCLUSIONS
  Cryptogenic chronic liver disease was the commonest cause of portal hypertension in adults, followed by alcohol or hepatitis B related chronic liver disease. Of patients with cryptogenic chronic liver disease who had liver biopsy, NCIPH was the commonest cause identified. Vascular liver disorders caused portal hypertension in 10 per cent of adult patients. Cryptogenic chronic liver disease was also the commonest cause in elderly patients.
authors.affiliation: Department of Hepatology, Christian Medical College, Vellore, India.
authors.forename: Ashish
authors.initials: A
authors.lastname: Goel
authors.forename: Kadiyala
authors.initials: K
authors.lastname: Madhu
authors.forename: Uday
authors.initials: U
authors.lastname: Zachariah
authors.forename: K G
authors.initials: KG
authors.lastname: Sajith
authors.forename: Jeyamani
authors.initials: J
authors.lastname: Ramachandran
authors.forename: Banumathi
authors.initials: B
authors.lastname: Ramakrishna
authors.forename: Sridhar
authors.initials: S
authors.lastname: Gibikote
authors.forename: John
authors.initials: J
authors.lastname: Jude
authors.forename: George M
authors.initials: GM
authors.lastname: Chandy
authors.forename: Elwyn
authors.initials: E
authors.lastname: Elias
authors.forename: C E
authors.initials: CE
authors.lastname: Eapen
mesh_terms: D000328:Adult; D000368:Aged; D001706:Biopsy; D058625:End Stage Liver Disease / Q000150:complications / Q000453:epidemiology / Q000503:physiopathology*; D005260:Female; D006509:Hepatitis B / Q000150:complications / Q000453:epidemiology / Q000503:physiopathology*; D006526:Hepatitis C / Q000150:complications / Q000453:epidemiology / Q000503:physiopathology*; D006521:Hepatitis, Chronic / Q000150:complications / Q000453:epidemiology / Q000503:physiopathology*; D006801:Humans; D006975:Hypertension, Portal / Q000150:complications / Q000453:epidemiology / Q000503:physiopathology*; D007194:India; D008099:Liver / Q000473:pathology; D008297:Male; D008875:Middle Aged; D062606:Tertiary Care Centers