Isolated hepatic non-obstructive sinusoidal dilatation, 20-year single center experience

Dharma Budi Sunjaya, Guilherme Piovezani Ramos, Manuel Bonfim Braga Neto, Ryan Lennon, Taofic Mounajjed, Vijay Shah, Patrick Sequeira Kamath, Douglas Simonetto

Research output: Contribution to journalArticle

Abstract

AIM To characterize isolated non-obstructive sinusoidal dilatation (SD) by identifying associated conditions, laboratory findings, and histological patterns. METHODS Retrospectively reviewed 491 patients with SD between 1995 and 2015. Patients with obstruction at the level of the small/large hepatic veins, portal veins, or right-sided heart failure were excluded along with history of cirrhosis, hepatic malignancy, liver transplant, or absence of electrocardiogram/cardiac echocardiogram. Liver histology was reviewed for extent of SD, fibrosis, red blood cell extravasation, nodular regenerative hyperplasia, hepatic peliosis, and hepatocellular plate atrophy (HPA). RESULTS We identified 88 patients with non-obstructive SD. Inflammatory conditions (32%) were the most common cause. The most common pattern of liver abnormalities was cholestatic (76%). Majority (78%) had localized SD to Zone III. Medication-related SD had higher proportion of portal hypertension (53%), ascites (58%), and median AST (113 U/L) and ALT (90 U/L) levels. Nineteen patients in our study died within one-year after diagnosis of SD, majority from complications related to underlying diseases. CONCLUSION Significant proportion of SD and HPA exist without impaired hepatic venous outflow. Isolated SD on liver biopsy, in the absence of congestive hepatopathy, requires further evaluation and portal hypertension should be rule out.

Original languageEnglish (US)
Pages (from-to)417-424
Number of pages8
JournalWorld Journal of Hepatology
Volume10
Issue number5
DOIs
StatePublished - May 27 2018

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Dilatation
Liver
Portal Hypertension
Atrophy
Purpura
Hepatic Veins
Portal Vein
Ascites
Liver Cirrhosis
Hyperplasia
Histology
Electrocardiography
Fibrosis
Heart Failure
Erythrocytes
Transplants
Biopsy
Neoplasms

Keywords

  • Hepatic plate atrophy
  • Sinusoidal dilatation
  • Sinusoidal obstruction syndrome

ASJC Scopus subject areas

  • Hepatology

Cite this

Isolated hepatic non-obstructive sinusoidal dilatation, 20-year single center experience. / Sunjaya, Dharma Budi; Ramos, Guilherme Piovezani; Neto, Manuel Bonfim Braga; Lennon, Ryan; Mounajjed, Taofic; Shah, Vijay; Kamath, Patrick Sequeira; Simonetto, Douglas.

In: World Journal of Hepatology, Vol. 10, No. 5, 27.05.2018, p. 417-424.

Research output: Contribution to journalArticle

Sunjaya, Dharma Budi ; Ramos, Guilherme Piovezani ; Neto, Manuel Bonfim Braga ; Lennon, Ryan ; Mounajjed, Taofic ; Shah, Vijay ; Kamath, Patrick Sequeira ; Simonetto, Douglas. / Isolated hepatic non-obstructive sinusoidal dilatation, 20-year single center experience. In: World Journal of Hepatology. 2018 ; Vol. 10, No. 5. pp. 417-424.
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abstract = "AIM To characterize isolated non-obstructive sinusoidal dilatation (SD) by identifying associated conditions, laboratory findings, and histological patterns. METHODS Retrospectively reviewed 491 patients with SD between 1995 and 2015. Patients with obstruction at the level of the small/large hepatic veins, portal veins, or right-sided heart failure were excluded along with history of cirrhosis, hepatic malignancy, liver transplant, or absence of electrocardiogram/cardiac echocardiogram. Liver histology was reviewed for extent of SD, fibrosis, red blood cell extravasation, nodular regenerative hyperplasia, hepatic peliosis, and hepatocellular plate atrophy (HPA). RESULTS We identified 88 patients with non-obstructive SD. Inflammatory conditions (32{\%}) were the most common cause. The most common pattern of liver abnormalities was cholestatic (76{\%}). Majority (78{\%}) had localized SD to Zone III. Medication-related SD had higher proportion of portal hypertension (53{\%}), ascites (58{\%}), and median AST (113 U/L) and ALT (90 U/L) levels. Nineteen patients in our study died within one-year after diagnosis of SD, majority from complications related to underlying diseases. CONCLUSION Significant proportion of SD and HPA exist without impaired hepatic venous outflow. Isolated SD on liver biopsy, in the absence of congestive hepatopathy, requires further evaluation and portal hypertension should be rule out.",
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AU - Lennon, Ryan

AU - Mounajjed, Taofic

AU - Shah, Vijay

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AB - AIM To characterize isolated non-obstructive sinusoidal dilatation (SD) by identifying associated conditions, laboratory findings, and histological patterns. METHODS Retrospectively reviewed 491 patients with SD between 1995 and 2015. Patients with obstruction at the level of the small/large hepatic veins, portal veins, or right-sided heart failure were excluded along with history of cirrhosis, hepatic malignancy, liver transplant, or absence of electrocardiogram/cardiac echocardiogram. Liver histology was reviewed for extent of SD, fibrosis, red blood cell extravasation, nodular regenerative hyperplasia, hepatic peliosis, and hepatocellular plate atrophy (HPA). RESULTS We identified 88 patients with non-obstructive SD. Inflammatory conditions (32%) were the most common cause. The most common pattern of liver abnormalities was cholestatic (76%). Majority (78%) had localized SD to Zone III. Medication-related SD had higher proportion of portal hypertension (53%), ascites (58%), and median AST (113 U/L) and ALT (90 U/L) levels. Nineteen patients in our study died within one-year after diagnosis of SD, majority from complications related to underlying diseases. CONCLUSION Significant proportion of SD and HPA exist without impaired hepatic venous outflow. Isolated SD on liver biopsy, in the absence of congestive hepatopathy, requires further evaluation and portal hypertension should be rule out.

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