A clinical review of congenital hepatic fibrosis diagnosed in adulthood: presentation, complications, and outcomes.

Autor:	Loeb L; Department of Internal Medicine, Mayo Clinic Florida, 4500 San Pablo Road, Jacksonville, FL 32224, USA., Lewis J; Department of Pathology, Mayo Clinic Florida, 4500 San Pablo Road, Jacksonville, FL 32224, USA., Peng Z; Clinical Trials and Biostatistics, Mayo Clinic, 4500 San Pablo Road, Jacksonville, FL 32224, USA., Heckman MG; Clinical Trials and Biostatistics, Mayo Clinic, 4500 San Pablo Road, Jacksonville, FL 32224, USA., Nakhleh R; Department of Pathology, Mayo Clinic Florida, 4500 San Pablo Road, Jacksonville, FL 32224, USA., Keaveny AP; Department of Transplantation, Mayo Clinic Florida, 4500 San Pablo Road, Jacksonville, FL 32224, USA. Electronic address: Keaveny.andrew@mayo.edu.
Jazyk:	angličtina
Zdroj:	Annals of hepatology [Ann Hepatol] 2024 Jan-Feb; Vol. 29 (1), pp. 101164. Date of Electronic Publication: 2023 Oct 04.
DOI:	10.1016/j.aohep.2023.101164
Abstrakt:	Introduction and Objectives: Congenital hepatic fibrosis (CHF) is a rare condition characterized by biliary tract changes and a geographic pattern of liver fibrosis. Liver biopsy is essential to confirm its diagnosis. The absence of specific clinical indicators in adults often leads to delays in diagnosis and management, while the natural history has not been well described. We sought to define the presentation and outcomes of adults with biopsy-proven CHF. Materials and Methods: A retrospective chart review was conducted of patients diagnosed with CHF by liver biopsy. Continuous variables were summarized with the sample median and range. Categorical variables were summarized with number and percentage of patients. Results: We identified 24 patients evaluated over a 20-year period, with a median age of 51 years (range 22-72 years) at initial presentation; 14 were male. The most common imaging findings were renal cysts (91.3%), splenomegaly (69.6%), and a cirrhotic-appearing liver (60.9%). The most commonly treated liver-related complications were cholangitis (45.8%), varices (45.8%), and hepatic encephalopathy (25%). Two patients died with a median length of follow-up of 2.9 years (range: 0.0-20.0 years). Two patients underwent transjugular intrahepatic portosystemic shunt (TIPS) placement to manage bleeding esophageal varices. Eight patients underwent liver transplantation (LT), the most common indication being decompensated disease (50%). Conclusions: CHF should be considered when patients present with cholangitis and/or complications of portal hypertension and have a cirrhotic appearing liver and renal cysts on imaging. Depending upon the disease severity, interventions such as TIPS or LT may be required. (Copyright © 2023 Fundación Clínica Médica Sur, A.C. Published by Elsevier España, S.L.U. All rights reserved.)
Databáze:	MEDLINE
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