Nodular regenerative hyperplasia, portal vein thrombosis, and avascular hip necrosis due to hyperhomocysteinaemia. Issue 7 (10th June 2005)

• Record Type: Journal Article
• Authors: Buchel, O; Roskams, T; Van Damme, B; Nevens, F; Pirenne, J; Fevery, J
• Is Part Of: Gut. Volume 54:Issue 7(2005)
• Page Start: 1021
• Page End: 1023
• Publication Date: 2005-06-10
• Subjects: homocystein -- nodular regenerative hyperplasia -- portal vein thrombosis -- avascular hip necrosis -- portal hypertension -- osteopenia; Gastroenterology -- Periodicals; 616.33
• DOI: 10.1136/gut.2004.055921
• Languages: English
• ISSNs: 0017-5749

Abstract

Abstract : A male patient with portal hypertension, portal vein thrombosis, spontaneous splenorenal shunt formation, and encephalopathy, thought to have post-hepatitis B cirrhosis, is described. His condition deteriorated and necessitated liver transplantation. In the explant liver, nodular regenerative hyperplasia with pronounced vascular lesions both in portal venules and in arterioles was found instead of classical cirrhosis. Two years post-transplant he developed bilateral ischaemic femur head necrosis. The three disorders (portal vein thrombosis, nodular regenerative hyperplasia, and ischaemic hip necrosis) seemed to be due to a common vasculopathy induced by hyperhomocyteinaemia. Genetic studies showed that he carried a mutation in the gene encoding for formation of methylenetetrahydrofolate reductase. Treatment with folic acid combined with pyridoxine (vitamin B6) and cyanocobalamin (vitamin B12) normalised his serum homocysteine levels.