TY - JOUR
T1 - Isolated hepatic non-obstructive sinusoidal dilatation, 20-year single center experience
AU - Sunjaya, Dharma Budi
AU - Ramos, Guilherme Piovezani
AU - Neto, Manuel Bonfim Braga
AU - Lennon, Ryan
AU - Mounajjed, Taofic
AU - Shah, Vijay
AU - Kamath, Patrick Sequeira
AU - Simonetto, Douglas Alano
N1 - Publisher Copyright:
© The Author(s) 2018.
PY - 2018/5/27
Y1 - 2018/5/27
N2 - 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.
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.
KW - Hepatic plate atrophy
KW - Sinusoidal dilatation
KW - Sinusoidal obstruction syndrome
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U2 - 10.4254/wjh.v10.i5.417
DO - 10.4254/wjh.v10.i5.417
M3 - Article
AN - SCOPUS:85047520174
SN - 1948-5182
VL - 10
SP - 417
EP - 424
JO - World Journal of Hepatology
JF - World Journal of Hepatology
IS - 5
ER -