A Case Report of Nodular Regenerative Hyperplasia of the Liver and Coeliac Disease

Document Type : Case report

Authors

1 Gastroenrologist and Hepatologist,Mashhad University of Medical Sciences, Mashhad, Iran

2 Assistant ProfessorofGastroenrology and Hepatology,Mashhad University of Medical Sciences, Mashhad, Iran

3 APCP-Pathologist,Mashhad, Iran

Abstract

Introduction
 
Coeliac disease (CD) is an autoimmune enteropathy triggered by gluten. Several hepatic disorders have been described in association with coeliac disease. Nodular regenerative hyperplasia (NRH) of the liver is a rare disorder and is a cause of non-cirrhotic portal hypertension.
 
[
 
Case report
 
A 22 y/o lady presented with portal hypertension, after all causes of chronic liver disease ruled out we checked for coeliac and it was positive. Liver biopsy was done and was compatible with nodular regenerative hyperplasia (NRH) of the liver.
 
Conclusion
 
As far as we know this is one of the rare cases of nodular regenerative hyperplasia of the liver in a patient with coeliac. Only three cases have been reported until now and seems we should think about coeliac in any patient suffering from chronic liver disease with unknown cause.

Keywords

References

1- Barbero Villares A ,Moreno Monteagudo JA ,Moreno Borque, Moreno Otero R. Hepatic involvement in coeliac
disease .Gastroenterol Hepatol 2008; 31:25-28.
2- Rubio-Tapia A, Murray JA . The liver in celiac disease .Hepatol 2007; 46:1650-1658.
3- Volta,Pathogenesis and clinical significance of liver injury in coeliac disease. Clin Rev Allergy Immunol 2009 ;36:62-70.
4- Ziol M ,Poirel H ,Kountchou GN, Boyer O, Mohand D, Mouthon L, et al. intrasinusoidal cytotoxic CD8 Tcells in
Nodular regenerative hyperplasia of the liver. Hum Pathol 2004; 35:1241-1251.
5- Maggiore G, Caprai S. Liver involvement in coeliac disease. Indian J Pediatr 2006; 73:809-811.
6- Wanless IR. Micronodular transformation (nodular regenerative hyperplasia) of the liver: a report of 64 cases among
2,500 autopsies and a new classification of benign hepatocellular nodules. Hepatology 1990; 11:787–797.
7- Perez Ruiz F , Orte Martinez FJ, Zea Mendoza AC, Ruiz del Arbol L, Moreno Caparros A.
Nodular regenerative hyperplasia of the liver in rheumatic diseases: report of seven cases and review of the literature.
Semin Arthritis Rheum 1991; 21:47–54.
8- Austin A, Campbell E, Lane P, Elias E .Nodular regenerative hyperplasia of the liver and coeliac disease: potential
role of IgA anticardiolipin antibody. Gut 2004; 53:1032-1034.
9- Al Mukhaizeem KA, Rosenberg A , Sherker AH. Nodular regenerative hyperplasia of the liver:an under-recognized
cause of portal hypertension in hematological disorders. Am J Hematol 2004; 75:225-230.
10- Ibarrola C, Colina F. Clinicopathological feathers of nine cases of non-cirrhotic portal hypertension; current
definitions and criteria are inadequate .Histopathology 2003; 42:251-264.
11- Reshamwala PA, Kleiner DE, Heller T. Nodular regenerative hyperplasia: not all nodules are created equal.
Hepatology 2006; 44:7-14.
12- Hillaire S, Bonte E , Denninger MH, Casadevall N, Cadranel JF, Lebrec D, et al. Idiopathic non-cirrhotic
intrahepatic portal hypertension in the west: a re-evaluation in 28 patients .Gut 2002; 51:275-280.
13- Sollid LM. Coeliac disease: dissecting a complex inflammatory disorder. Nat Rev Immunol 2002; 2:647–655.
14- Moss SF, Attia L, Scholes JV, Walters JR, Holt PR. Increased small intestinal apoptosis in coeliac disease. Gut
1996; 39:811–817.
15- Biecker E ,Trebicka J ,Fischer Hp , Sauerbruch T, Lammert F.Portal hypertention and nodular regenerative
hyperplasia in a patients with coeliac disease . Z Gatroentrol 2006; 44:395-398.
16- Clein R,Goller S, BianchiL. Nodular regenerative hyperplasia of the liver a manifestation of organ specific
antiphospholipid syndrome? Immunobiology 2003; 207:51-57. 
medical journal of mashhad university of medical sciences
Volume 54, Issue 3 - Serial Number 3
September and October 2010
Pages 185-188

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