Nodular Regenerative Hyperplasia of the Liver in a Patient With Celiac Disease

Riestra, Sabino; Domı́nguez, Francisco; Rodrigo, Luı́s

doi:10.1097/00004836-200110000-00014

Cited by 13 publications

(6 citation statements)

References 28 publications

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“…Although previous reported cases also seemed to have portal hypertension with such a disease association, 9,10 ours are different because all have splenomegaly, instead of an atrophic or normal-sized spleen. Although hyposplenism is a known feature of CD, 18 in the present series all patients had hematologic signs of hypersplenism secondary to portal hypertension.…”

Section: Discussionmentioning

confidence: 51%

“…It is an uncommon hepatic histopathologic condition associated to many systemic diseases, such as antiphospholipid syndrome, rheumatoid arthritis, and drug hepatotoxicity. 9,10 Arterial blood gas abnormalities or abnormal results of pulmonary function tests that develop in the course of chronic liver diseases with portal hypertension, such as cirrhosis and NRH, can occur in as much as 50%. CD was diagnosed fortuitously in 1 of 14 patients with NRH.…”

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confidence: 99%

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Celiac Disease Associated With Nodular Regenerative Hyperplasia, Pulmonary Abnormalities, and IgA Anticardiolipin Antibodies

Cançado¹,

Medeiros²,

Deguti³

et al. 2006

Journal of Clinical Gastroenterology

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The association of nodular regenerative hyperplasia with celiac disease is not as well established as it is with hepatopulmonary syndrome and portopulmonary hypertension. IgA anticardiolipin antibodies were reported recently in celiac patients with nodular regenerative hyperplasia. The subject of this study was the description of pulmonary abnormalities and IgA anticardiolipin antibodies in celiac patients with noncirrhotic portal hypertension. Five patients with portal hypertension were investigated to diagnose its etiology. Celiac disease was diagnosed by means of autoantibody reactivity and duodenal biopsies. Liver histology revealed nodular regenerative hyperplasia in four patients and suggested its presence in 1 case. Two cyanotic patients had severe hypoxemia with a confirmed diagnosis of hepatopulmonary syndrome. Another case exhibited features of hepatopulmonary syndrome with increased levels of arterial pulmonary pressure. The remaining 2 cases had slight abnormalities of arterial oxygenation. Three patients had reactivity to IgA anticardiolipin antibodies. The concomitance of celiac disease and nodular regenerative hyperplasia, two infrequent conditions, raises suspicion of there being a nonfortuitous coincidence. Pulmonary abnormalities, and especially hepatopulmonary syndrome, are described for the first time in association with celiac disease and nodular regenerative hyperplasia.

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Section: Discussionmentioning

confidence: 51%

mentioning

confidence: 99%

Celiac Disease Associated With Nodular Regenerative Hyperplasia, Pulmonary Abnormalities, and IgA Anticardiolipin Antibodies

Cançado¹,

Medeiros²,

Deguti³

et al. 2006

Journal of Clinical Gastroenterology

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“…In the cases reviewed, different clinical situations explained the development of hemorrhagic events, such as coagulopathy due to vitamin K malabsorption [4,15,20,23,32,44,45,47], celiac crisis [8,13], LHS [14,15,17,18,[33][34][35][36][37][38][39][40], portal hypertension [23], or digestive tumors [19,21,25,41].…”

Section: Discussionmentioning

confidence: 99%

“…In 7 published cases [15,20,21,23,34,44,45], the CD diagnosis was already known before the hemorrhagic event, while in the rest, the CD diagnosis followed the hemorrhagic occurrence.…”

Section: Diagnostic Approachmentioning

confidence: 99%

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Hemorrhagic Events in Adult Celiac Disease Patients. Case Report and Review of the Literature

Dima

Jurcuţ²,

Manolache³

et al. 2018

JGLD

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Background & Aims: Celiac disease (CD) presents with a wide spectrum of extra-digestive symptoms, including hemorrhagic manifestations. The aim of this review was to conduct an extensive analysis of the hemorrhagic events reported in adult CD patients.Methods: Case report and review of the literature. Pubmed (MEDLINE) database search from January 1970 onwards was performed using the medical subject headings [MeSH] terms “celiac disease” AND “blood coagulation disorders”, “hemorrhage”, “hematoma”, “hematuria”, “hemoptysis”, “epistaxis”, “hemosiderosis”.Only case reports were identified on the search theme. Information on patients’ characteristics, diagnostic features, coagulation parameters, symptomatology duration, and evolution under treatment were systematically collected and summarized.Results: We present the case of a 40-year-old man hospitalized for spontaneous muscular hematomas, in whom CD was diagnosed. We performed a review of the literature and summarized the published case reports of 46 CD patients, aged between 19 and 74 years, 64% of male gender. In 25% of cases, the symptomatology was present for more than 5 years prior to CD diagnosis. The clinical hemorrhagic events were as follows: 15 patients had gastrointestinal bleeding, 9 hemoptysis, 4 epistaxis, 6 hematuria, 8 cutaneous hematoma, petechia or ecchymoses, and only in 1 case hemarthrosis, hemorrhagic vesicular dermatitis, subcortical hemorrhage, or adrenal hemorrhage. Sixty percent of the patients had digestive symptoms, while the rest had only extradigestive CD involvement. The Lane Hamilton syndrome was defined in 15 patients. The evolution under a gluten-free diet was favorable in most cases.Conclusion: This review of case reports aims to increase awareness to hemorrhagic events, rare but possible life-threatening conditions, as part of the CD clinical spectrum. To the best of our knowledge, this is the first review of all types of hemorrhagic events in adult CD patients.

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