Hepatoportal Sclerosis as a Cause of Portal Hypertension in a Colombian HIV patient without Cirrhosis
DOI:
https://doi.org/10.22516/25007440.28Keywords:
Tru-cut liver biopsy, hepatoportal sclerosis, non-cirrhotic portal hypertension, human immunodeficiency virus, anti-retroviral therapyAbstract
Background: Hepatoportal sclerosis manifests as non-cirrhotic portal hypertension. Its etiology appears to be related to alterations in the idiopathic micro-vasculature of the liver. Manifestations of hepatoportal sclerosis include upper gastrointestinal bleeding, pancytopenia, splenomegaly and non-cirrhotic portal hypertension. We present the first reported case of hepatoportal sclerosis in Colombia which occurred in an HIV positive patient.
Methods: A 60-year-old male HIV patient positive was admitted to our institution because of ascites and upper digestive tract bleeding due to esophageal and fundal varices. Management required taking a liver
biopsy.
Results: A Tru-Cut biopsy needle was used to take a liver biopsy sample percutaneously. The biopsy revealed six to eight portal tracts with preserved architectural parenchyma, perivenular fibrosis and severe
pericentral sinusoidal dilatation.
Conclusions: Hepatoportal sclerosis is a cause of morbidity in HIV-positive patients and should be considered in each patient manifesting non-cirrhotic portal hypertension associated with upper gastrointestinal bleeding. However, further research is necessary to describe the relationship between the development of intrahepatic alterations (microthrombosis), HIV, and the use of anti-retroviral therapy, particularly the use of didanosine.
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