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Porto-Sinusoidal Vascular Disease Associated to Oxaliplatin: An Entity to Think about It
Portal sinusoidal vascular disease is a presinusoidal cause of portal hypertension (PHT) of unknown etiology, characterized by typical manifestations of PHT (esophageal varices, ascites, portosystemic collaterals), plaquetopenia and splenomegaly with a gradient of portal pressure slightly increased,...
Autores principales: | , , , , , , , , , , , , , |
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Formato: | Online Artículo Texto |
Lenguaje: | English |
Publicado: |
MDPI
2019
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Materias: | |
Acceso en línea: | https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6952805/ https://www.ncbi.nlm.nih.gov/pubmed/31771307 http://dx.doi.org/10.3390/cells8121506 |
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author | Puente, Angela Fortea, Jose Ignacio Del Pozo, Carmen Huelin, Patricia Cagigal, Maria Luisa Serrano, Marina Cabezas, Joaquin Arias Loste, Maria Teresa Iruzubieta, Paula Cuadrado, Antonio Llerena, Susana Lopez, Carlos Fábrega, Emilio Crespo, Javier |
author_facet | Puente, Angela Fortea, Jose Ignacio Del Pozo, Carmen Huelin, Patricia Cagigal, Maria Luisa Serrano, Marina Cabezas, Joaquin Arias Loste, Maria Teresa Iruzubieta, Paula Cuadrado, Antonio Llerena, Susana Lopez, Carlos Fábrega, Emilio Crespo, Javier |
author_sort | Puente, Angela |
collection | PubMed |
description | Portal sinusoidal vascular disease is a presinusoidal cause of portal hypertension (PHT) of unknown etiology, characterized by typical manifestations of PHT (esophageal varices, ascites, portosystemic collaterals), plaquetopenia and splenomegaly with a gradient of portal pressure slightly increased, according to the presinusoidal nature of the PHT. A few cases in the literature have shown a relationship between oxaliplatin and the development of presinusoidal portal hypertension, years after the chemotherapy for colorectal cancer (therefore, different to sinusoidal obstruction syndrome). There are three mechanisms through which oxaliplatin can cause sinusoidal damage: (1) damage at the level of endothelial cells and stimulates the release of free radicals and depletion of glutathione transferase, with altering the integrity of the sinusoidal cells. The damage in the endothelial sinusoidal cells allows to erythrocytes to across into the Dissé space and formation of perisinusoidal fibrosis, (2) the appearance of nodular regenerative hyperplasia is favored by the chronic hypoxia of the centrilobular areas and, finally, (3) oxaliplatin can generate an obliteration of the blood capillaries and zones of parenchymal extinction. These three facts can develop, in a minority of cases, the appearance of a presinusoidal increase of portal pressure, which typically appears years after the completion of chemotherapy and sometimes is underdiagnosed until variceal bleeding, ascites or encephalopathy appear. The knowledge of this pathology is essential to be able to perform an early diagnostic and consult to the hepatologist. |
format | Online Article Text |
id | pubmed-6952805 |
institution | National Center for Biotechnology Information |
language | English |
publishDate | 2019 |
publisher | MDPI |
record_format | MEDLINE/PubMed |
spelling | pubmed-69528052020-01-23 Porto-Sinusoidal Vascular Disease Associated to Oxaliplatin: An Entity to Think about It Puente, Angela Fortea, Jose Ignacio Del Pozo, Carmen Huelin, Patricia Cagigal, Maria Luisa Serrano, Marina Cabezas, Joaquin Arias Loste, Maria Teresa Iruzubieta, Paula Cuadrado, Antonio Llerena, Susana Lopez, Carlos Fábrega, Emilio Crespo, Javier Cells Review Portal sinusoidal vascular disease is a presinusoidal cause of portal hypertension (PHT) of unknown etiology, characterized by typical manifestations of PHT (esophageal varices, ascites, portosystemic collaterals), plaquetopenia and splenomegaly with a gradient of portal pressure slightly increased, according to the presinusoidal nature of the PHT. A few cases in the literature have shown a relationship between oxaliplatin and the development of presinusoidal portal hypertension, years after the chemotherapy for colorectal cancer (therefore, different to sinusoidal obstruction syndrome). There are three mechanisms through which oxaliplatin can cause sinusoidal damage: (1) damage at the level of endothelial cells and stimulates the release of free radicals and depletion of glutathione transferase, with altering the integrity of the sinusoidal cells. The damage in the endothelial sinusoidal cells allows to erythrocytes to across into the Dissé space and formation of perisinusoidal fibrosis, (2) the appearance of nodular regenerative hyperplasia is favored by the chronic hypoxia of the centrilobular areas and, finally, (3) oxaliplatin can generate an obliteration of the blood capillaries and zones of parenchymal extinction. These three facts can develop, in a minority of cases, the appearance of a presinusoidal increase of portal pressure, which typically appears years after the completion of chemotherapy and sometimes is underdiagnosed until variceal bleeding, ascites or encephalopathy appear. The knowledge of this pathology is essential to be able to perform an early diagnostic and consult to the hepatologist. MDPI 2019-11-24 /pmc/articles/PMC6952805/ /pubmed/31771307 http://dx.doi.org/10.3390/cells8121506 Text en © 2019 by the authors. Licensee MDPI, Basel, Switzerland. This article is an open access article distributed under the terms and conditions of the Creative Commons Attribution (CC BY) license (http://creativecommons.org/licenses/by/4.0/). |
spellingShingle | Review Puente, Angela Fortea, Jose Ignacio Del Pozo, Carmen Huelin, Patricia Cagigal, Maria Luisa Serrano, Marina Cabezas, Joaquin Arias Loste, Maria Teresa Iruzubieta, Paula Cuadrado, Antonio Llerena, Susana Lopez, Carlos Fábrega, Emilio Crespo, Javier Porto-Sinusoidal Vascular Disease Associated to Oxaliplatin: An Entity to Think about It |
title | Porto-Sinusoidal Vascular Disease Associated to Oxaliplatin: An Entity to Think about It |
title_full | Porto-Sinusoidal Vascular Disease Associated to Oxaliplatin: An Entity to Think about It |
title_fullStr | Porto-Sinusoidal Vascular Disease Associated to Oxaliplatin: An Entity to Think about It |
title_full_unstemmed | Porto-Sinusoidal Vascular Disease Associated to Oxaliplatin: An Entity to Think about It |
title_short | Porto-Sinusoidal Vascular Disease Associated to Oxaliplatin: An Entity to Think about It |
title_sort | porto-sinusoidal vascular disease associated to oxaliplatin: an entity to think about it |
topic | Review |
url | https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6952805/ https://www.ncbi.nlm.nih.gov/pubmed/31771307 http://dx.doi.org/10.3390/cells8121506 |
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