Clinical characteristics and natural history of porto‐sinusoidal vascular disease: A cohort study of 234 patients in China

医学 门脉高压 胃肠病学 腹水 内科学 失代偿 胃静脉曲张 病态的 肝硬化 静脉曲张 阶段(地层学) 肝病 自然史 生物 古生物学
作者
Yu Zhang,Qing‐Fang Xiong,Yan-Dan Zhong,Duxian Liu,Hong‐Li Liu,Li Wang,Zhixiang Du,Miaoyang Chen,Yufeng Zheng,Yongfeng Yang
出处
期刊:Liver International [Wiley]
卷期号:44 (9): 2329-2340
标识
DOI:10.1111/liv.16002
摘要

Abstract Background and Aims Porto‐sinusoidal vascular disease (PSVD) is an under‐recognized and under‐diagnosed disease. The purpose of this study was to investigate the clinical features and prognosis of PSVD. Methods The patients who underwent liver biopsies were analyzed retrospectively. The clinical and pathological data were reviewed and screened according to the latest diagnostic criteria of PSVD. Results A total of 234 patients were diagnosed as PSVD, including 103 patients presented with portal hypertension (PH) and 131 patients without PH. At baseline, the alanine aminotransferase (ALT) and γ‐glutamyl transpeptidase (GGT) levels were higher in the no‐PH group. The liver stiffness increased in the PH group. In histological review, obliterative portal venopathy, sinusoidal dilatation and architectural disturbance were more common in the PH group, while portal tract abnormalities were more widely distributed in the no‐PH group. After a median follow‐up of 43.6 months, the survival rate of patients with baseline liver decompensation was 76.0%, and that of patients at a liver compensated stage in the PH group was 98.7%. First variceal bleeding occurred in 13.8% of patients with gastric‐oesophageal varices. None of the patients in the no‐PH group developed portal hypertension during follow‐up. Conclusions PSVD can manifest as PH or mild liver enzyme abnormalities. There are significant differences in pathological features among patients with different clinical manifestations. Recurrent ascites are the main cause of death in PSVD patients. However, patients without PH have a slow disease progression, with recurrent elevated GGT levels being their main clinical feature.
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