Nodular Regenerative Hyperplasia – an under-recognized vascular disorder of liver

Publication date: Available online 20 January 2020Source: Pathology - Research and PracticeAuthor(s): Neha Bakshi, Natasha Gulati, Archana Rastogi, Abhijit Chougule, Chhagan Bihari, Ankur JindalaAbstractIntroductionNodular regenerative hyperplasia (NRH) is a rare hepatic vascular disorder which is often associated with wide variety of systemic diseases. Intrahepatic microvascular injury and subsequent altered perfusion state leads to development of non-cirrhotic portal hypertension in many of these patients. Diagnosis of NRH often remains unsuspected clinically and liver biopsy is essential for the diagnosis and exclusion of fibrosis. We herein, present clinicopathological features of 22 NRH cases. In addition we assessed CK7 and CD34 expression in hepatocytes and sinusoidal endothelial cells respectively.ResultsMost of the cases were associated with systemic disorders, predominantly immunological, inflammatory and drug-related injuries. Signs and symptoms of portal hypertension were found in 86.4% patients. Majority of the patients showed a predominant mild cholestatic pattern of liver function tests. Nearly all the (21/22) cases showed CK7 positivity in centrizonal hepatocytes which ranged from
Source: Pathology Research and Practice - Category: Pathology Source Type: research

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Conclusion Myocardial perfusion defects, both in RV and LV, occur even in asymptomatic or mildly symptomatic patients with Eisenmenger syndrome.
Source: Nuclear Medicine Communications - Category: Nuclear Medicine Tags: Original Articles Source Type: research
Authors: Boucly A, Savale L, Vuillard C, Turpin M, Jaïs X, Montani D, Humbert M, Sitbon O Abstract Right ventricular failure (RVF) is a common cause of admission to the intensive care unit and its presence is a major prognostic factor in acute pulmonary embolism (PE) and chronic pulmonary hypertension (PH). RVF results from an incapacity of the RV to adapt to an increase in afterload so it can become critical in acute PE and chronic PH. The presence of RVF in cases of acute PE with haemodynamic instability is an indication for thrombolytic therapy. RVF represents the most common cause of death in chronic PH. F...
Source: Revue des Maladies Respiratoires - Category: Respiratory Medicine Tags: Rev Mal Respir Source Type: research
We appreciate Dr Gandhi's interest in our article and find his comments insightful regarding the role of systemic hypertension as a risk factor for neovascular glaucoma (NVG) in central retinal vein occlusions (CRVO).1 As seen in the renal glomeruli, chronic systemic hypertension induces thickening of the intima, thereby decreasing compliance of individual arterioles.2,3 This ultimately results in impaired vascular autoregulation and perfusion to the end organ. In the case of the retina, we see similar findings in hypertensive retinopathy with narrowing of the arterioles, disruption of the blood –retina barrier, and ...
Source: American Journal of Ophthalmology - Category: Opthalmology Authors: Tags: Correspondence Source Type: research
ConclusionsWeight loss and therapies targeting HC, TNF- α and CCL2, whether separately or in combination, may be beneficial to modulate rates of CSF secretion and/or resistance to CSF drainage pathways, both factors likely contributing to the raised intracranial pressure (ICP) observed in female IIH patients with obesity.
Source: Fluids and Barriers of the CNS - Category: Neuroscience Source Type: research
Publication date: Available online 8 February 2020Source: Canadian Journal of CardiologyAuthor(s): Ernesto L. SchiffrinAbstractLarge conduit arteries and the microcirculation participate in the mechanisms of elevation of blood pressure (BP). Large vessels play roles predominantly in older subjects, with stiffening progressing after middle age leading to increases in systolic BP found in most humans with aging. Systolic BP elevation and increased pulsatility penetrate deeper into the distal vasculature, leading to microcirculatory injury and remodeling, and associated endothelial dysfunction. The result is target organ dama...
Source: Canadian Journal of Cardiology - Category: Cardiology Source Type: research
Coronary artery tortuosity (CAT) is a prevalent angiographic finding commonly associated with aging, hypertension, atherosclerosis and other conditions. Preliminary evidence suggests that degradation of elastin, a key component of extracellular matrix in the vascular wall, may be responsible for the development of CAT. The clinical significance of CAT should be considered in several aspects. First, coronary flow alteration associated with CAT may result in myocardial ischemia owing to reduced perfusion pressure distal to the tortuous segment. Second, increased and oscillatory shear stress in the tortuous vessel may promote...
Source: Coronary Artery Disease - Category: Cardiology Tags: Reviews in Depth Source Type: research
Abstract Atherosclerotic renal artery stenosis (ARAS) can cause secondary hypertension, progressive decline in renal function, and cardiac complications. Recent randomized controlled trials including the CORAL study have not reported the benefit of renal artery stenting compared to medical therapy alone to improve renal function or reduce cardiovascular and renal events in the enrolled patients with ARAS. However, observational evidence indicating the benefits of angioplasty in the selected high-risk patients with ARAS has been increasing. Thus, the timely correction of stenosis through angioplasty may have a bene...
Source: American Journal of Hypertension - Category: Cardiology Authors: Tags: Am J Hypertens Source Type: research
Pediatric extrahepatic portal vein occlusion (EHPVO) may result in adverse sequelae of portal hypertension, such as severe hypersplenism, thrombocytopenia, poor neurocognitive and somatic growth, and variceal bleeding (1). The preferred treatment for selected patients is a meso-Rex bypass (MRB) creation, restoring physiological perfusion of the intrahepatic portal vein through a conduit from the superior mesenteric vein to the left portal vein (1). The MRB is associated with reduced portal hypertensive complications, improved coagulation, somatic growth, and cognition (2).
Source: Journal of Vascular and Interventional Radiology : JVIR - Category: Radiology Authors: Tags: Letter to the Editor Source Type: research
Publication date: 2020Source: European Journal of Radiology Open, Volume 7Author(s): Hiroki Kamada, Hideki Ota, Yosuke Terui, Koichiro Sugimura, Shigefumi Fukui, Hiroaki Shimokawa, Kei TakaseAbstractPulmonary tumor thrombotic microangiopathy (PTTM) is a specific type of tumor embolism in the small and medium pulmonary arteries, leading to rapid progressive pulmonary hypertension. Antemortem diagnosis of PTTM is extremely difficult. We encountered three patients who were histopathologically or clinically diagnosed with PTTM. In all cases, lung perfused blood volume (PBV) images on dual-energy computed tomography (CT) demons...
Source: European Journal of Radiology Open - Category: Radiology Source Type: research
Suprarenal abdominal aortic coarctation (SAAC) is a congenital midaortic syndrome that develops owing to a developmental anomaly in the fusion of the embryonic dorsal aortae. This condition is associated with severe hypertension, which is usually the indication for intervention. Open surgery is the primary treatment and it typically involves thoracoaortic bypass (TAB), and less commonly patch aortoplasty (PA). Bypass to the visceral vessels has also been performed in conjunction with TAB or PA. The majority undergoing intervention for SAAC are children and adolescents; therefore, the benefits of surgical intervention must ...
Source: Journal of Vascular Surgery - Category: Surgery Authors: Tags: Invited commentary Source Type: research
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