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Chronic lymphocytic leukemia with portal hypertension and without liver involvement : A case report underlining the roles of increased spleno-portal blood flow and “protective" sinusoidal vasoconstriction

Journal Volume 66 - 2003
Issue Fasc.4 - Case reports
Author(s) J.Y. Wilputte, J.P. Martinet, P. Nguyen, P. Damoiseaux, J. Rahier, A. Geubel
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(1) Service de gastroentérologie ; (4) Service d'anatomopathologie, cliniques UCL St Luc, Bruxelles ; (2) Service de gastroentérologie, cliniques UCL de Mont-Godinne, Yvoir ; (3) Service de médecine interne, C.H. Dinant.

We report the case of a 72-year-old woman with well-controlled chronic lymphocytic leukemia (CLL) and splenomegaly who developed portal hypertension with bleeding oesophageal varices in the absence of liver fibrosis or regenerative nodular hyperplasia at surgical wedge liver biopsy. The hepatic venous pressure gradi- ent (HVPG) was elevated and splenectomy resulted in both its nor- malisation and the regression of oesophageal varices. This case shows the potential for an increased spleno-portal flow to generate severe portal hypertension likely through a "protective" sinusoidal vasoconstriction. (Acta gastroenterol. belg., 2003, 66, 303-306).

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