Diagnosis and treatment of portal hypertension caused by rare diseases
-
摘要: 少见、罕见疾病所致门静脉高压症多属于窦前性(肝前)或肝后性门静脉高压症。因多数为非肝硬化门静脉高压症,故肝静脉压力梯度不能准确反映其门静脉压力,临床诊治存在较大困难。此类疾病种类较多,重点介绍了6种少见、罕见疾病所致门静脉高压症的机理和治疗进展,并就目前的治疗现状进行了总结,希望对提高临床医生对此类疾病的认识有所帮助。Abstract: Portal hypertension caused by rare diseases is mostly presinusoidal (prehepatic) or posthepatic.It is non-cirrhotic portal hypertension in most cases, so hepatic venous pressure gradient cannot accurately reflect the portal venous pressure of such patients, which causes difficulties in clinical diagnosis and treatment.There are many diseases in this category.This article introduces the advances in the pathogenesis and treatment of portal hypertension caused by six rare diseases and summarizes the current status of treatment, in order to help improve the awareness of these diseases among clinicians.
-
Key words:
- hypertension, portal /
- rare diseases /
- diagnosis /
- therapy
-
[1]BARGE S, GRANDO V, NAULT JC, et al.Prevalence and clinical significance of nodular regenerative hyperplasia in liver biopsies[J].Liver Int, 2016, 36 (7) :1059-1066. [2]HARTLEB M, GUTKOWSKI K, MILKIEWICZ P.Nodular regenerative hyperplasia:Evolving concepts on underdiagnosed cause of portal hypertension[J].World J Gastroenterol, 2011, 17 (11) :1400-1409. [3]BISSONNETTE J, GENEREUX A, COTE J, et al.Hepatic hemodynamics in 24 patients with nodular regenerative hyperplasia and symptomatic portal hypertension[J].J Gastroenterol Hepatol, 2012, 27 (8) :1336-1340. [4]LAL BK, STANLEY A.Nodular regenerative hyperplasia related portal hypertension in a patient with hypogammaglobulinaemia[J].World J Gastroenterol, 2013, 19 (22) :3502-3504. [5]TRIPATHI D, FERGUSON JW, THERAPONDOS G, et al.Review article:recent advances in the management of bleeding gastric varices[J].Aliment Pharmacol Ther, 2006, 24 (1) :1-17. [6]MANZIA TM, GRAVANTE G, di PAOLO D, et al.Liver transplantation for the treatment of nodular regenerative hyperplasia[J].Dig Liver Dis, 2011, 43 (12) :929-934. [7]ALVAREZ-LARRAN A, ABRALDES JG, CERVANTES F, et al.Portal hypertension secondary to myelofibrosis:A study of three cases[J].Am J Gastroenterol, 2005, 100 (10) :2355-2358. [8]TAN HK, LEOW WQ, CHANG PE.Ruxolitinib for the Treatment of Portal Hypertension in a Patient With Primary Myelofibrosis[J].Gastroenterology, 2017.[Epub ahead of print] [9]VERSTOVSEK S, MESA RA, GOTLIB J, et al.A doubleblind, placebo-controlled trial of ruxolitinib for myelofibrosis[J].N Engl J Med, 2012, 366 (9) :799-807. [10]VERSTOVSEK S, MESA RA, GOTLIB J, et al.Long-term treatment with ruxolitinib for patients with myelofibrosis:5-year update from the randomized, double-blind, placebocontrolled, phase 3 COMFORT-I trial[J].J Hematol Oncol, 2017, 10 (1) :55. [11]MARCHETTI M, BAROSI G, CERVANTES F, et al.Which patients with myelofibrosis should receive ruxolitinib therapy?ELN-SIE evidence-based recommendations[J].Leukemia, 2017, 31 (4) :882-888. [12]YAN M, GEYER H, MESA R, et al.Clinical features of patients with philadelphia-negative myeloproliferative neoplasms complicated by portal hypertension[J].Clin Lymphoma Myeloma Leuk, 2015, 15 (1) :e1-e5. [13]GENTILUCCI UV, GALLO P, PERRONE G, et al.Non-cirrhotic portal hypertension with large regenerative nodules:Adiagnostic challenge[J].World J Gastroenterol, 2011, 17 (20) :2580-2584. [14]GRTZEN J, HUNKA LM, VONNAHME M, et al.γ-Glutamyl transferase is an independent biomarker of splanchnic thrombosis in patients with myeloproliferative neoplasm[J].Medicine (Baltimore) , 2016, 95 (20) :e3355. [15]REILLY CR, BABUSHOK DV, MARTIN K, et al.Multicenter analysis of the use of transjugular intrahepatic portosystemic shunt (TIPS) for management of MPN-associated portal hypertension[J].Am J Hematol, 2017, 92 (9) :909-914. [16]SAMUELSON BT, VESELY SK, CHAI-ADISAKSOPHA C, et al.The impact of ruxolitinib on thrombosis in patients with polycythemia vera and myelofibrosis:A meta-analysis[J].Blood Coagul Fibrinolysis, 2016, 27 (16) :648-652. [17]PIERI L, PAOLI C, ARENA U, et al.Safety and efficacy of ruxolitinib in splanchnic vein thrombosis associaged with myeloproliferative neoplasms[J].Am J Hematol, 2017, 92 (9) :187-195. [18]ZHAO G, WU ZY, ZHANG B, et al.Diagnosis and treatment of portal hypertension secondary to myeloproliferative disorders:A report of three cases[J].J Dig Dis, 2011, 12 (4) :312-316. [19]GIANOTTI R, CHARLES H, HYMES K, et al.Treatment of gastric varices with partial splenic embolization in a patient with portal vein thrombosis and a myeloproliferative disorder[J].World J Gastroenterol, 2014, 20 (39) :14495-14499. [20] WEHRMAN A, KRIEGERMEIER A, WEN J, et al.Diagnosis and management of hepatobiliary complications in autosomal recessive polycystic kidney disease[J].Front Pediatr, 2017, 5:124. [21]UMAR J, JOHN S.Caroli Disease[M].SourceStatPearls[Internet].Treasure Island (FL) :Stat Pearls Publishing, 2018. [22]MOSLIM MA, GUNASEKARAN G, VOGT D, et al.Surgical management of Caroli's disease:Single center experience and review of the literature[J].J Gastrointest Surg, 2015, 19 (11) :2019-2027. [23]JANOWSKI K, GOLISZEK M, CIELECKA-KUSZYK J, et al.Congenital hepatic fibrosis in a 9-year-old female patienta case report[J].Clin Exp Hepatol, 2017, 3 (3) :176-179. [24]MAZIGH MS, ALOUI N, FETNI I, et al.Congential hepatic fibrosis in children.Report of 9 cases and review of the literature[J].Tunis Med, 2006, 84 (3) :182-188. [25]SRINATH A, SHNEIDER BL.Congenital hepatic fibrosis in a 9-year-old female patient-a case report[J].Clin Exp Hepatol, 2017, 3 (3) :176-179. [26]MILLWALA F, SEGEV DL, THULUVATH PJ, et al.Caroli's disease and outcomes after liver transplantation[J].Liver Transpl, 2008, 14 (1) :11-17. [27]CHANDOK N.Polycystic liver disease:A clinical review[J].Ann Hepatol, 2012, 11 (6) :819-826. [28]QIAN Q.Isolated polycystic liver disease[J].Adv Chronic Kidney Dis, 2010, 17 (2) :181-189. [29]GEVERS TJ, DRENTH JP.Somatostatin analogues for treatment of polycystic liver disease[J].Curr Opin Gastroenterol, 2011, 27 (3) :294-300. [30]HOGAN MC, MASYUK TV, PAGE L, et al.Somatostatin analog therapy for severe polycystic liver disease:Results after 2years[J].Nephrol Dial Transplant, 2012, 27 (9) :3532-3539. [31]QIAN Q, DU H, KING BF, et al.Sirolimus reduces polycystic liver volume in ADPKD patients[J].J Am Soc Nephrol, 2008, 19 (3) :631-638. [32]KHAN MS, KHAN Z, JAVAID T, et al.Isolated polycystic liver disease:An unusual cause of recurrent variceal bleed[J].Case Rep Gastrointest Med, 2018, 2018:2902709. [33]van KEIMPEMA L, NEVENS F, ADAM R, et al.Excellent survival after liver transplantation for isolated polycystic liver disease:An European liver transplant registry study[J].Transpl Int, 2011, 24 (12) :1239-1245. [34]JAMES SP, STROMEYER FW, CHANG C, et al.Liver abnormalities in patients with Gaucher's disease[J].Gastroenterology, 1981, 80 (1) :126-133. [35]CANO RUIZ A, MARTíN SCAPA A, MONESCILLO FRANCIA A, et al.Gaucher’s disease type 1:An infrequent cause of portal hypertension[J].Ann Med Interna, 1998, 15 (9) :483-484. [36]BANDYOPADHYAY R, BANDYPADHYAY S, MAITY PK.Gauchers disease presenting with portal hypertension[J].Indian Pediatr, 2011, 48 (10) :801-802. [37]REGENBOOG M, van DUSSEN L, VERHEIJ J, et al.Hepatocellular carcinoma in Gaucher disease:An international case series[J], J Inherit Metab Dis, 2018, 41 (5) :819-827. [38]ADAR T, ILAN Y, ELSTEIN D, et al.Liver involvement in Gaucher disease-review and clinical approach[J].Blood Cells Mol Dis, 2018, 68:66-73. [39]AYTO RM, HUGHES DA, JEEVARATNAM P, et al.Longterm outcomes of liver transplantation in type 1 Gaucher disease[J].Am J Transplant, 2010, 10 (8) :1934-1039.
本文二维码
计量
- 文章访问数: 1784
- HTML全文浏览量: 41
- PDF下载量: 447
- 被引次数: 0