PT  - JOURNAL ARTICLE
AU  - TZU-YAO LIAO
AU  - CHUANG-CHI LIAW
AU  - HUI-CHING HSU
AU  - CHIA-HSUN HSIEH
AU  - JOHN WEN-CHENG CHANG
AU  - YU-HSIANG JUAN
TI  - Extrahepatic Portal Venous Obstruction With Hepatic Enzyme Elevation Resembling Hepatitis in Patients With Cancer
AID  - 10.21873/invivo.11658
DP  - 2019 Sep 01
TA  - In Vivo
PG  - 1697--1702
VI  - 33
IP  - 5
4099  - http://iv.iiarjournals.org/content/33/5/1697.short
4100  - http://iv.iiarjournals.org/content/33/5/1697.full
SO  - In Vivo2019 Sep 01; 33
AB  - Background/Aim: Chemotherapy is often halted due to abnormal liver function resembling hepatitis. But the cause can be extrahepatic portal venous obstruction (EHPVO) with hepatic enzyme elevation rather than being an adverse effect of chemotherapy. We investigated EHPVO with hepatic enzyme elevation in patients with cancer. Patients and Methods: Data of these hospitalized patients with solid tumors between January 2013 and September 2017 were collected. The criteria for study inclusion were: (i) Extrahepatic malignancy; (ii) computed tomographic scans showing a tumor with external compression of the extrahepatic portal vein; and (iii) serum aminotransferase (AST) or alanine transaminase (ALT) level three times above the normal value. Results: Thirteen out of 377 (3%) patients developed EHPVO with hepatic enzyme elevation, as demonstrated from computed tomographic scan. Four cases (31%) also had vascular thrombosis (three portal vein and one inferior vena cava). Serum AST increased from 34±11 to 169±94 U/l. ALT increased from 9±38 to 177±104 U/l. There was no relationship of EHPVO with viral markers and cirrhosis. Six cases received chemotherapy with liver function improvement. Conclusion: EHPVO occurred in patients with metastatic cancer, leading to hepatic enzyme elevation resembling hepatitis without hepatitis risk factors and cirrhosis. Before withholding chemotherapy due to hepatic enzyme elevation, the possibility of EHPVO should firstly be excluded.