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Gut-derived Prothrombotic Factors May Contribute to Non-cirrhotic Intrahepatic Portal Hypertension


A research team examined 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.

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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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