Abstract
Nodular regenerative hyperplasia (NRH) is a rare liver condition in which widespread benign transformation of the hepatic parenchyma into small regenerative nodules occur, leading to development of non-cirrhotic portal hypertension. Conditions associated with NRH include rheumatologic, hematological, autoimmune, infectious, neoplastic, or drug-related etiology. Accurate diagnosis is made on liver biopsy, showing diffuse micronodular transformation in the absence of fibrosis. Here, we present the second case in world literature of a middle-aged man presenting with recent onset sleep reversal and memory loss with darkening of skin for four years associated with systemic manifestations, in whom porto-systemic shunt syndrome due to NRH secondary to Behcet’s disease was eventually diagnosed.
Highlights
Nodular regenerative hyperplasia (NRH) is an uncommon cause of non-cirrhotic intrahepatic portal hypertension
We present the second case in world literature of a middle-aged man presenting with recent onset sleep reversal and memory loss with darkening of skin for four years associated with systemic manifestations, in whom porto-systemic shunt syndrome due to NRH secondary to Behcet’s disease was eventually diagnosed
Nodular regeneration of the liver was first defined by Steiner in 1959 characterized by small regenerative nodules distributed evenly throughout the liver in the absence of fibrosis leading to sinusoidal portal hypertension (PHT) [1,2]
Summary
Philips 1 , Rajaguru Paramaguru 2 , Lijesh Kumar 3 , Padmanabha Shenoy 4 , Philip Augustine 5. 1. Hepatology and Liver Transplant Medicine, PVS Memorial Hospital 2. Rheumatology, Care Clinics, Sree Sudheendra Medical Mission 5. Gastroenterology, PVS Institute of Digestive Diseases, PVS Memorial Hospital
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