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. 1979 Jun;20(6):531–537. doi: 10.1136/gut.20.6.531

Idiopathic portal hypertension (perisinusoidal fibrosis) after renal transplantation.

C Nataf, G Feldmann, D Lebrec, C Degott, J M Descamps, B Rueff, J P Benhamou
PMCID: PMC1412455  PMID: 381128

Abstract

We report the cases of two renal transplant recipients suffering from idopathic portal hypertension, a condition characterised by increased portal venous pressure in the absence of both histological lesion of the liver and obstruction of the portal vein. In these two patients, perisnusoidal fibrosis, invisible by light microscopy, was demonstrated by electron microscopy; it is suggested that partial obstruction of hepatic sinusoids by perisinusoidal fibrosis could be the mechanism for increased portal venous pressure in all the patients with idiopathic portal hypertension. In these two patients, who received 6-mercaptopurine and azathioprine, perisinusoidal fibrosis might be the consequence of prolonged administration of these drugs.

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Selected References

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  1. BENHAMOU J. P., GUILLEMOT R., TRICOT R., LEGER L., FAUVERT R. [Essential portal hypertension]. Presse Med. 1962 Nov 21;70:2397–2399. [PubMed] [Google Scholar]
  2. Boyer J. L., Hales M. R., Klatskin G. "Idiopathic" portal hypertension due to occlusion of intrahepatic portal veins by organized thrombi. A study based on postmortem vinylite-injection corrosion and dissection of the intrahepatic vasculature in 4 cases. Medicine (Baltimore) 1974 Jan;53(1):77–91. doi: 10.1097/00005792-197401000-00003. [DOI] [PubMed] [Google Scholar]
  3. Boyer J. L., Sen Gupta K. P., Biswas S. K., Pal N. C., Basu Mallick K. C., Iber F. L., Basu A. K. Idiopathic portal hypertension. Comparison with the portal hypertension of cirrhosis and extrahepatic portal vein obstruction. Ann Intern Med. 1967 Jan;66(1):41–68. doi: 10.7326/0003-4819-66-1-41. [DOI] [PubMed] [Google Scholar]
  4. Du Vivier A., Munro D. D., Verbov J. Treatment of psoriasis with azathioprine. Br Med J. 1974 Jan 12;1(5897):49–51. doi: 10.1136/bmj.1.5897.49. [DOI] [PMC free article] [PubMed] [Google Scholar]
  5. Freiberger Z., Anuras S., Koff R. S., Bonney W. W. Chronic active hepatitis without hepatitis B antigenemia in renal transplant recipients. Report of three cases. Gastroenterology. 1974 Jun;66(6):1187–1194. [PubMed] [Google Scholar]
  6. Grimaud J. A., Borojevic R. Chronic human schistosomiasis mansoni. Pathology of the Disse's space. Lab Invest. 1977 Mar;36(3):268–273. [PubMed] [Google Scholar]
  7. Huet P. M., Guillaume E., Cote J., Légaré A., Lavoie P., Viallet A. Noncirrhotic presinusoidal portal hypertension associated with chronic arsenical intoxication. Gastroenterology. 1975 May;68(5 Pt 1):1270–1277. [PubMed] [Google Scholar]
  8. Iber F. L. Obliterative portal venopathy of the liver and "idiopathic portal hypertension". Ann Intern Med. 1969 Sep;71(3):660–661. doi: 10.7326/0003-4819-71-3-660. [DOI] [PubMed] [Google Scholar]
  9. Kluge T., Sommerschild H., Flatmark A. Sinusoidal portal hypertension. Surgery. 1970 Aug;68(2):294–300. [PubMed] [Google Scholar]
  10. Lascari A. D., Givler R. L., Soper R. T., Hill L. F. Portal hypertension in a case of acute leukemia treated with antimetabolites for ten years. N Engl J Med. 1968 Aug 8;279(6):303–306. doi: 10.1056/NEJM196808082790608. [DOI] [PubMed] [Google Scholar]
  11. Lortat-Jacob J. L., Dupuy R., Fauvert R., Maillard J. N., Benhamou J. P. Les blocs intrahépatiques en dehors des cirrhoses communes. Résultats de l'anastomose porto-cave. Bull Mem Soc Med Hop Paris. 1967 Nov 3;118(12):1069–1074. [PubMed] [Google Scholar]
  12. MILLER M. C., BRANDT J. L. Portal hypertension in the absence of both liver disease and vascular obstruction. Am J Dig Dis. 1962 May;7:442–448. doi: 10.1007/BF02232363. [DOI] [PubMed] [Google Scholar]
  13. Mendenhall C. L., Sherman J., Chedid A. Intermittent idiopathic portal hypertension. A case report. Gastroenterology. 1974 Jul;67(1):142–148. [PubMed] [Google Scholar]
  14. Mikkelsen W. P., Edmondson H. A., Peters R. L., Redeker A. G., Reynolds T. B. Extra- and intrahepatic portal hypertension without cirrhosis (hepatoportal sclerosis). Ann Surg. 1965 Oct;162(4):602–620. doi: 10.1097/00000658-196510000-00006. [DOI] [PMC free article] [PubMed] [Google Scholar]
  15. Morris J. S., Schmid M., Newman S., Scheuer P. J., Sherlock S. Arsenic and noncirrhotic portal hypertension. Gastroenterology. 1974 Jan;66(1):86–94. [PubMed] [Google Scholar]
  16. Palosuo T., Kano K., Anthone S., Gerbasi J. R., Milgrom F. Circulating immune complexes after kidney transplantation. Transplantation. 1976 Apr;21(4):312–316. doi: 10.1097/00007890-197604000-00007. [DOI] [PubMed] [Google Scholar]
  17. Podurgiel B. J., McGill D. B., Ludwig J., Taylor W. F., Muller S. A. Liver injury associated with methotrexate therapy for psoriasis. Mayo Clin Proc. 1973 Nov;48(11):787–792. [PubMed] [Google Scholar]
  18. Russell R. M., Boyer J. L., Bagheri S. A., Hruban Z. Hepatic injury from chronic hypervitaminosis a resulting in portal hypertension and ascites. N Engl J Med. 1974 Aug 29;291(9):435–440. doi: 10.1056/NEJM197408292910903. [DOI] [PubMed] [Google Scholar]
  19. Sama S. K., Bhargava S., Nath N. G., Talwar J. R., Nayak N. C., Tandon B. N., Wig K. L. Noncirrhotic portal fibrosis. Am J Med. 1971 Aug;51(2):160–169. doi: 10.1016/0002-9343(71)90234-8. [DOI] [PubMed] [Google Scholar]
  20. Smith P. M., Crossley I. R., Williams D. M. Portal hypertension in vinyl-chloride production workers. Lancet. 1976 Sep 18;2(7986):602–604. doi: 10.1016/s0140-6736(76)90668-1. [DOI] [PubMed] [Google Scholar]
  21. TISDALE W. A., KLATSKIN G., GLENN W. W. Portal hypertension and bleeding esophageal varices; their occurrence in the absence of both intrahepatic and extrahepatic obstruction of the portal vein. N Engl J Med. 1959 Jul 30;261(5):209–218. doi: 10.1056/NEJM195907302610501. [DOI] [PubMed] [Google Scholar]
  22. Talerman A., Thompson R. B. Hepatic fibrosis in a child possibly due to prolonged methotrexate. J Clin Pathol. 1966 Jan;19(1):81–82. doi: 10.1136/jcp.19.1.81. [DOI] [PMC free article] [PubMed] [Google Scholar]
  23. Tandon B. N., Lakshminarayanan R., Bhargava S., Nayak N. C., Sama S. K. Ultrastructure of the liver in non-cirrhotic portal fibrosis with portal hypertension. Gut. 1970 Nov;11(11):905–910. doi: 10.1136/gut.11.11.905. [DOI] [PMC free article] [PubMed] [Google Scholar]
  24. Thomas L. B., Popper H., Berk P. D., Selikoff I., Falk H. Vinyl-chloride-induced liver disease. From idiopathic portal hypertension (Banti's syndrome) to Angiosarcomas. N Engl J Med. 1975 Jan 2;292(1):17–22. doi: 10.1056/NEJM197501022920104. [DOI] [PubMed] [Google Scholar]
  25. Villeneuve J. P., Huet P. M., Joly J. G., Marleau D., Côté J., Légaré A., Lafortune M., Lavoie P., Viallet A. Idiopathic portal hypertension. Am J Med. 1976 Oct;61(4):459–464. doi: 10.1016/0002-9343(76)90323-5. [DOI] [PubMed] [Google Scholar]
  26. Zarday Z., Veith F. J., Gliedman M. L., Soberman R. Irreversible liver damage after azathioprine. JAMA. 1972 Nov 6;222(6):690–691. [PubMed] [Google Scholar]

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