Portal vein thrombosis in liver cirrhosis

Kinjo, Nao; Kawanaka, Hirofumi; Akahoshi, Tomohiko; Matsumoto, Yoshihiro; Kamori, Masahiro; Nagao, Yuhei; Hashimoto, Noriyuki; Uehara, Hideo; Tomikawa, Morimasa; Shirabe, Ken; Maehara, Yoshihiko

doi:10.4254/wjh.v6.i2.64

Cited by 60 publications

(54 citation statements)

References 84 publications

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“…Factors predicting recanalization were recent onset (<6 months) of the thrombus and partial PVT [211][212][213]. Treatment prolongation resulted in higher rates of recanalization and a lower likelihood of extension.…”

Section: Anti-coagulation For the Prevention/treatment Of Portal Veinmentioning

confidence: 98%

Hemostatic balance in patients with liver cirrhosis: Report of a consensus conference

Andriulli

Tripodi

Angeli

et al. 2016

Digestive and Liver Disease

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a b s t r a c tPatients with cirrhosis present with hemostatic alterations secondary to reduced availability of procoagulant and anti-coagulant factors. The net effect of these changes is a rebalanced hemostatic system. The Italian Association of the Study of the Liver (AISF) and the Italian Society of Internal Medicine (SIMI) promoted a consensus conference on the hemostatic balance in patients with cirrhosis. The consensus process started with the review of the literature by a scientific board of experts and ended with a formal consensus meeting in Rome in December 2014. The statements were graded according to quality of evidence and strength of recommendations, and approved by an independent jury. The statements presented here highlight strengths and weaknesses of current laboratory tests to assess bleeding and thrombotic risk in cirrhotic patients, the pathophysiology of hemostatic perturbations in this condition, and outline the optimal management of bleeding and thrombosis in patients with liver cirrhosis.

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Section: Anti-coagulation For the Prevention/treatment Of Portal Veinmentioning

confidence: 98%

Hemostatic balance in patients with liver cirrhosis: Report of a consensus conference

Andriulli

Tripodi

Angeli

et al. 2016

Digestive and Liver Disease

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“…Portal vein thrombosis is a frequent finding of liver cirrhosis, with a prevalence range of 0.6% to 15.8%. 6 In the present study, we found 2 cases with portal vein thrombosis (6%). We detected periodic acid-Schiffdiastase-and periodic acid-Schiff-positive granules in 7 of 33 cases (21%).…”

Section: Discussionmentioning

confidence: 58%

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Karadağ

Tolan²,

Şamdancı³

et al. 2017

Exp Clin Transplant

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Objectives: Wilson disease is a rare genetic disease with clinical and histopathologic differential diagnostic challenges. In this study, we evaluated the histopathologic findings of explanted livers in Wilson disease, with special emphasis on copper histochemistry. Materials and Methods: Our study group was recruited by reviewing archived histopathology reports and the liver transplant clinic patient records retrospectively for patients who had liver transplant for Wilson disease between January 2010 and June 2015, at Turgut Ozal Medical Center. Archival slides were reevaluated. When needed, relevant clinical and laboratory data were obtained from patient medical records. Results: During the selected period, there were 33 patients fitting the study criteria (22 male, 11 female, mean age of 22 ± 11 y). All patients had mild to moderate septal inflammation. We found that 29 patients (88%) showed glycogenated hepatocyte nuclei and 27 patients (79%) showed nuclear pleomorphism. Other histopathologic findings were cholestasis (48%) and macrovesicular steatosis (39%). There was no special finding in hilar regions except for 2 patients who had recanalized portal vein thrombosis. In terms of copper histochemistry, 2 copper stains, Timm silver sulfide and rhodanine, were performed in all cases, with orcein staining only done for 25 of the cases. Positivity rates for these copper stains were 85%, 82%, and 36%. Periodic acid-Schiffdiastase-and periodic acid-Schiff-positive granules were detected in 7 of 33 patients (21%). Iron deposition was seen in 12 patients (focal and/or minimal in 11, more than focal in 1). There was no dysplasia or malignancy in any of the patients. Conclusions.On routine hematoxylin and eosinstained slides, detection of glycogenated hepatocyte nuclei and the finding of the nuclear pleomorphism should alert the pathologist for the possibility of Wilson disease, especially with cryptogenic liver disease. Timm stain is a more convenient histochemical stain in revealing copper deposition in liver. Key words: Copper histochemistry, Transplant, Wilson disease IntroductionWilson disease is a rare inborn metabolic disease involving copper metabolism. The spectrum of clinical findings is variable. More often, the clinical picture is as liver disease shown at early ages (especially in children and young adults). Liver disease can present both as acute and chronic forms. Most of the symptoms are nonspecific, as with the liver histologic findings on routine hematoxylin and eosin-stained slides. Histologic abnormalities include steatosis, glycogenated hepatocyte nuclei, inflammation, and variable hepatocellular anisonucleosis. 1,2 From a pathologist's perspective, when evaluating the liver biopsies, especially in cryptogenic cases and with chronic hepatitis and cirrhosis, Wilson disease should be included in the differential diagnosis when these findings are observed. 1 Evaluation of copper deposition by histo chemistry is an important step in histologic examination.

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“…Although the factors associated with recanalization or the extent of thrombosis has been investigated, the actual effect of PVT treatment on the natural history of cirrhosis has not been determined. 28 Stratification of patients with liver cirrhosis according to risk of PVT may enable those at greater risk to be provided preventive therapy for PVT. A randomized controlled trial evaluating the safety and efficacy of low-molecularweight heparin in prevention of PVT in patients with liver cirrhosis found that the actuarial probability of PVT was lower in patients who were treated with enoxaparin than those who were not.…”

Section: Discussionmentioning

confidence: 99%

Untitled

2016

Exp Clin Transplant

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Portal vein thrombosis in liver cirrhosis

Cited by 60 publications

References 84 publications

Hemostatic balance in patients with liver cirrhosis: Report of a consensus conference

Hemostatic balance in patients with liver cirrhosis: Report of a consensus conference

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