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Gut-derived Prothrombotic Factors May Contribute to Non-cirrhotic Intrahepatic Portal Hypertension
http://www.celiac.com/articles/22162/1/Gut-derived-Prothrombotic-Factors-May-Contribute-to-Non-cirrhotic-Intrahepatic-Portal-Hypertension/Page1.html
Jefferson Adams

Jefferson Adams is a freelance writer living in San Francisco. His poems, essays and photographs have appeared in Antioch Review, Blue Mesa Review, CALIBAN, Hayden's Ferry Review, Huffington Post, the Mississippi Review, and Slate among others.

He is a member of both the National Writers Union, the International Federation of Journalists, and covers San Francisco Health News for Examiner.com.

 
By Jefferson Adams
Published on 06/22/2010
 
A research team set out to examine gut diseases and prognostic factors tied to non-cirrhotic intrahepatic portal hypertension.

Celiac.com 06/22/10 - A research team set out to examine gut diseases and prognostic factors tied to non-cirrhotic intrahepatic portal hypertension. The team included C. E. Eapen, Peter Nightingale, Stefan G. Hubscher, Peter J. Lane, Timothy Plant, Dimitris Velissaris, and Elwyn Elias.

The prognosis for non-cirrhotic intrahepatic portal hypertension (NCIPH) is usually benign. Assessment of a cohort study followed-up at a tertiary referral center leads the research team to hypothesize that gut-derived prothrombotic factors may contribute to the pathogenesis and prognosis of NCIPH.

The team conducted a retrospective analysis of celiac disease indicators in 34 NCIPH patients. They also looked for associated gut conditions.

Survival rates for transplant-free NCIPH patients from first presentation of symptoms was 94% (SE: 4.2%) at one year, 84% (6.6%) at 5-years, and 69% (9.8%) at 10-years.

Sixteen of the patients (53%) showed decompensated liver disease. Three (9%) patients suffered ulcerative colitis, while five of 31 (16%) had clinical celiac disease. Kaplan–Meier analysis showed that celiac disease patients was a predictor of lower transplant-free survival (p = 0.018) rates.

Multivariable Cox regression analysis revealed that other predictors of reduced transplant-free survival included older age at first NCIPH presentation, hepatic encephalopathy, and portal vein thrombosis.

Just over one-third (36%) of patients with NCIPH showed substantially higher initial serum IgA anticardiolipin antibody (CLPA), compared to 6% with Budd–Chiari syndrome (p = 0.032 using Fisher’s exact test) and no celiac disease patients without concomitant liver disease (p = 0.007).

In addition to noting factors affecting prognosis, the team found that just over half (53%) of NCIPH cases resulted in liver failure.

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