Idiopathic portal hypertension following viral hepatitis(B) and rheumatoid arthritis: Report of an autopsy case.

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An autopsy case of idiopathic portal hypertension (IPH), 62 years old female, was reported. The onset of illness was acute viral hepatitis 20 years ago. Thereafter, she had chranic hepatitis (HBsAg+, HBsAb-, HBeAb+, HBcAb+) and rheumatoid arthritis with positive ANA and Anti DNA. Pancytopenia, splenomegaly, ascites and minor change of liver function tests were seen in her course. Hematoemesis from esophagial varicies occurred and she died of hemorrhagic shock. On autopsy, cirrhotic change of the liver was not seen. There was no significant change in the extrahepatic portal vein. Histology of the liver showed fibosis of Glissan's sheath, marked stenasis of peripheral branches of portal vein and moderate lymphocytic infiltration in some Glisson's sheaths.<BR>It is suggested, in the present case, that viral hepatitis is a trigger of development of IPH, and that an immunological abnarmality being documented as rheumatoid arthritis and presence of autoantibodies may participate in development of IPH.
社団法人日本肝臓学会の論文