Year 2016 / Volume 108 / Number 2
Original
Idiopathic portal hypertension regarding thiopurine treatment in patients with inflammatory bowel disease

79-83

DOI: 10.17235/reed.2015.3954/2015

Cristina Suárez Ferrer, Elba Llop Herrera, Marta Calvo Moya, María Isabel Vera Mendoza, Irene González Partida, Yago González Lama, Virginia Matallana Royo, José Luis Calleja Panero, Luis Abreu García,

Abstract
Introduction: The possibility of developing idiopathic portal hypertension has been described with thiopurine treatment despite compromises the prognosis of these patients, the fact its true prevalence is unknown. Material and methods: A cross-sectional study was conducted in a cohort of inflammatory bowel disease (IBD) patients followed at our unit, to determine the prevalence of diagnosis of idiopathic portal hypertension (IPH) and its relationship with thiopurine treatment. Results: At the time of the analysis, 927/1,419 patients were under treatment with thiopurine drugs (65%). A total of 4 patients with IBD type Crohn’s disease with idiopathic portal hypertension probably related to the thiopurine treatment were identified (incidence of 4.3 cases per 1,000). Seventy-five percent of patients started with signs or symptoms of portal hypertension. Only one patient was asymptomatic but the diagnosis of IPH because of isolated thrombocytopenia is suspected. However, note that all patients had thrombocytopenia previously. Abdominal ultrasound with fibroscan, hepatic vein catheterization and liver biopsy were performed on all of them as part of the etiology of portal hypertension. In the abdominal ultrasound, indirect portal hypertension data were observed in all patients (as splenomegaly) cirrhosis was also ruled out. The fibroscan data showed significant liver fibrosis (F2-F3). Conclusion: Idiopathic portal hypertension following thiopurine treatment in IBD patients is a rare occurrence, but it must be borne in mind in the differential diagnosis for early diagnosis, especially in patients undergoing thiopurine treatment over a long period. The presence of thrombocytopenia is often the only predictor of its development in the preclinical stage.
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26/02/2016 14:33:57
Buenos días, me resulta importante, conocer esta causa de hipertesion portal idiopatica, como bien ustedes han concluido es de poca frecuencia, pero tener presente este factor causante en el momento de valorar el estado general de nuestros pacientes nos alerta sobre factores predictivos que favorecen el riesgo de la aparición de la entidad, así como también que conducta seguir.


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Citation tools
Suárez Ferrer C, Llop Herrera E, Calvo Moya M, Vera Mendoza M, González Partida I, González Lama Y, et all. Idiopathic portal hypertension regarding thiopurine treatment in patients with inflammatory bowel disease. 3954/2015


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Publication history

Received: 05/08/2015

Accepted: 24/09/2015

Online First: 15/12/2015

Published: 01/02/2016

Article revision time: 33 days

Article Online First time: 132 days

Article editing time: 180 days


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