Nodular regenerative hyperplasia of the liver: survival and associated features in a UK case series

Morris, J.M., Oien, K.A. , McMahon, M., Forrest, E.H., Morris, J.M., Stanley, A.J. and Campbell, S. (2010) Nodular regenerative hyperplasia of the liver: survival and associated features in a UK case series. European Journal of Gastroenterology and Hepatology, 22(8), pp. 1001-1005. (doi: 10.1097/MEG.0b013e3283360021)

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Publisher's URL: http://dx.doi.org/10.1097/MEG.0b013e3283360021

Abstract

Aims Nodular regenerative hyperplasia (NRH) is a rarely identified liver disorder. It is characterized histologically by nodular hepatocyte regeneration without significant fibrosis, and clinically by portal hypertension and abnormal liver function tests (LFTs). Survival data in an unselected cohort after diagnosis of NRH have not been previously described. This study aims to identify a regional cohort with NRH, to determine survival after diagnosis and to assess the relative frequency of associated conditions. Methods Patients were identified retrospectively from liver biopsy reports within pathology databases, over a 13-year period from Glasgow, Scotland, UK. Case notes were retrieved, clinical information extracted and survival was determined. Results Forty-two patients were identified (19 males). Common presenting features were abnormal LFTs (predominantly cholestatic) (76%) and portal hypertension (9.5%). None had severe liver dysfunction (Child-Pugh score A: 81%, B: 19%, C: 0%). Varices were detected in 26%, and portal hypertension was detected in 31%. There were five (12%) variceal bleeds, one fatal. The patients were subdivided into four groups according to associated clinical conditions: malignancy (29%), prothrombotic (21%), rheumatological (24%) and idiopathic/other (26%). Mean survival was 8.1 years, although survival was highly variable, and was associated with age and associated disease, but not with portal hypertension or varices. No patients in the rheumatological subgroup died. Conclusion NRH is usually associated with malignant, prothrombotic or rheumatological conditions. Survival is highly variable and related to age and the underlying disease process, but not to portal hypertension overall. Liver function remains well preserved

Item Type:Articles
Status:Published
Refereed:Yes
Glasgow Author(s) Enlighten ID:Stanley, Dr Adrian and Campbell, Dr Stewart and Forrest, Dr Ewan and Oien, Professor Karin and Morris, Dr John
Authors: Morris, J.M., Oien, K.A., McMahon, M., Forrest, E.H., Morris, J.M., Stanley, A.J., and Campbell, S.
College/School:College of Medical Veterinary and Life Sciences > Institute of Cancer Sciences
Journal Name:European Journal of Gastroenterology and Hepatology
ISSN:0954-691X

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