title: Idiopathic portal hypertension regarding thiopurine treatment in patients with inflammatory bowel disease.
abstract: BACKGROUND
  The possibility of developing idiopathic portal hypertension has been described with thiopurine treatment despite compromises the prognosis of these patients, the fact its true prevalence is unknown.
  
  
  METHODS
  A cross-sectional study was conducted in a cohort of inflammatory bowel disease (IBD) patients followed at our unit, to determine the prevalence of diagnosis of idiopathic portal hypertension (IPH) and its relationship with thiopurine treatment.
  
  
  RESULTS
  At the time of the analysis, 927/1,419 patients were under treatment with thiopurine drugs (65%). A total of 4 patients with IBD type Crohn's disease with idiopathic portal hypertension probably related to the thiopurine treatment were identified (incidence of 4.3 cases per 1,000). Seventy-five percent of patients started with signs or symptoms of portal hypertension. Only one patient was asymptomatic but the diagnosis of IPH because of isolated thrombocytopenia is suspected. However, note that all patients had thrombocytopenia previously. Abdominal ultrasound with fibroscan, hepatic vein catheterization and liver biopsy were performed on all of them as part of the etiology of portal hypertension. In the abdominal ultrasound, indirect portal hypertension data were observed in all patients (as splenomegaly) cirrhosis was also ruled out. The fibroscan data showed significant liver fibrosis (F2-F3).
  
  
  CONCLUSIONS
  Idiopathic portal hypertension following thiopurine treatment in IBD patients is a rare occurrence, but it must be borne in mind in the differential diagnosis for early diagnosis, especially in patients undergoing thiopurine treatment over a long period. The presence of thrombocytopenia is often the only predictor of its development in the preclinical stage.
authors.affiliation: GASTROENTEROLOGIA, Hospital Puerta de Hierro Majadahonda. Madrid, ESPAÑA.
authors.forename: Cristina
authors.initials: C
authors.lastname: Suárez Ferrer
authors.affiliation: GASTROENTEROLOGIA , Hospital Universitario Puerta de Hierro Majadahonda. Madrid, ESPAÑA.
authors.forename: Elba
authors.initials: E
authors.lastname: Llop Herrera
authors.affiliation: GASTROENTEROLOGIA , Hospital Universitario Puerta de Hierro Majadahonda. Madrid, españa.
authors.forename: Marta
authors.initials: M
authors.lastname: Calvo Moya
authors.affiliation: AP DIGESTIVO, Hospital Universitario Puerta de Hierro Majadahonda. Madrid, ESPAÑA.
authors.forename: María Isabel
authors.initials: MI
authors.lastname: Vera Mendoza
authors.affiliation: DIGESTIVO, Hospital Universitario Puerta de Hierro Majadahonda. Madrid, España.
authors.forename: Irene
authors.initials: I
authors.lastname: González Partida
authors.affiliation: Servicio de Gastroenterología y Hepatología, Hospital Universitario Puerta de Hierro, España.
authors.forename: Yago
authors.initials: Y
authors.lastname: González Lama
authors.affiliation: GASTROENTEROLOGIA , Hospital Universitario Puerta de Hierro Majadahonda. Madrid, ESPAÑA.
authors.forename: Virginia
authors.initials: V
authors.lastname: Matallana Royo
authors.affiliation: Ap. Digestivo, Hospital Universitario Puerta de Hierro, España.
authors.forename: José Luis
authors.initials: JL
authors.lastname: Calleja Panero
authors.affiliation: Ap. Digestivo, Hospital Universitario Puerta de Hierro, España.
authors.forename: Luis
authors.initials: L
authors.lastname: Abreu García
mesh_terms: D000328:Adult; D000368:Aged; D001379:Azathioprine / Q000009:adverse effects / Q000627:therapeutic use; D003430:Cross-Sectional Studies; D005260:Female; D006801:Humans; D006975:Hypertension, Portal / Q000139:chemically induced* / Q000175:diagnosis / Q000453:epidemiology; D007166:Immunosuppressive Agents / Q000009:adverse effects* / Q000627:therapeutic use; D015212:Inflammatory Bowel Diseases / Q000188:drug therapy*; D008103:Liver Cirrhosis / Q000139:chemically induced* / Q000175:diagnosis / Q000453:epidemiology; D008297:Male; D015122:Mercaptopurine / Q000009:adverse effects* / Q000627:therapeutic use; D008875:Middle Aged; D010198:Pancytopenia / Q000139:chemically induced* / Q000175:diagnosis / Q000453:epidemiology; D013163:Splenomegaly / Q000139:chemically induced* / Q000175:diagnosis / Q000453:epidemiology; D016896:Treatment Outcome; D000094724:Idiopathic Noncirrhotic Portal Hypertension
chemical_list: D007166:Immunosuppressive Agents; D015122:Mercaptopurine; D001379:Azathioprine