P-7 CLINICAL AND HISTOPATHOLOGICAL FEATURES OF THIRTY-FIVE OBLITERATIVE PORTAL VENOPATHY PATIENTS AND POTENTIAL ROLE OF XENOBIOTICS

Introduction

Classically described in the group of non-cirrhotic portal hypertension, Obliterative Portal Venopathy (OPV) is a spectral disease, which can be diagnosed before the manifestations of portal hypertension. Its causes are still unknowing and the identification of possible risk factors are important to further etiological investigation.

Aims

To describe the characteristics of OPV patients and potential risk factors.

Methods

Thirty five consecutive adults patients with OPV were retrospectively selected on histological criteria, defined by phlebosclerosis, disappearance and reduction of the diameter of portal vein branch and exclusion of cirrhosis. Clinical and laboratory data were analyzed. Clinically significant portal hypertension was considerated in presence of esophageal varices or ascites. No explanted liver was considered.

Results

Mean age at diagnosis was 46 ± 11 years old predominantly female (83%). Clinically significant portal hypertension was found in 26% of cases. The most frequent indication for liver biopsy was liver enzymes elevation, mostly GGT increase in 76% of patients, average 234 IU/L (upper limit of normality up to 40 IU/L) and ALT in 60%, mean 72 IU/L (38 IU/L). Possible risk factors were described in Table 1. Compatible chronology between start medication and biochemical change was considered to attribute suspicion to the xenobiotic.

Conclusion

Most OPV patients could be diagnosed before manifestation of clinical portal hypertension, additionally, GGT and ALT elevation are frequent findings and more than half os the patients were exposed to xenobiotics before the enzymes changes. Finally xenobiotics, autoimmunity and thrombophilia are possible risk factors and should be investigated.