What are intrahepatic, predominantly presinusoidal causes of portal hypertension?

Updated: Nov 30, 2017
  • Author: Jesus Carale, MD; Chief Editor: BS Anand, MD  more...
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Answer

More specifically, intrahepatic, predominantly presinusoidal causes of resistance to flow include the following:

  • Schistosomiasis (early stage)

  • Primary biliary cirrhosis (early stage)

  • Idiopathic portal hypertension (early stage) [11]

  • Nodular regenerative hyperplasia - The pathogenesis probably is obliterative venopathy; the presence of nodules that press on the portal system has also been postulated to play a role, although nodularity is present in most cases without clinical evidence of portal hypertension

  • Myeloproliferative diseases - These act via direct infiltration by malignant cells

  • Polycystic disease

  • Hepatic metastasis

  • Granulomatous diseases (sarcoidosis, tuberculosis) - Clinical liver dysfunction is rare in sarcoidosis, whereas portal hypertension is an unusual, although well-recognized, manifestation of hepatic sarcoidosis; sarcoid granulomas frequently localize in the portal areas, resulting in injury to the portal veins


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