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 Detalle_Publicacion

Porto-Sinusoidal Vascular Disease Associated to Oxaliplatin: An Entity to Think about It

Abstract: 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.

 Fuente: Cells . 2019 Nov 24;8(12):1506

Editorial: MDPI

 Año de publicación: 2019

Nº de páginas: 10

Tipo de publicación: Artículo de Revista

 DOI: 10.3390/cells8121506

ISSN: 2073-4409

Url de la publicación: https://www.doi.org/10.3390/cells8121506

Autores/as

PUENTE, ANGELA

FORTEA, JOSE IGNACIO

POZO, CARMEN DEL

HUELIN, PATRICIA

CAGIGAL, MARIA LUISA

SERRANO, MARINA

CABEZAS, JOAQUIN

ARIAS LOSTE, MARIA TERESA

IRUZUBIETA, PAULA

CUADRADO, ANTONIO

LLERENA, SUSANA

LOPEZ, CARLOS