Exploring the link: Porto-sinusoidal vascular disorder and inflammatory bowel disease - A comprehensive narrative review

Nicola Pugliese; Lucia Giuli; Elisabetta Mastrorocco; Francesco Santopaolo; Giacomo Marcozzi; Cristina Bezzio; Arianna Dal Buono; Roberto Gabbiadini; Antonio Gasbarrini; Francesca Romana Ponziani; Alessandro Armuzzi; Alessio Aghemo

doi:10.1016/j.dld.2023.11.021

Exploring the link: Porto-sinusoidal vascular disorder and inflammatory bowel disease - A comprehensive narrative review

Dig Liver Dis. 2023 Dec 2:S1590-8658(23)01039-3. doi: 10.1016/j.dld.2023.11.021. Online ahead of print.

Affiliations

¹ Department of Biomedical Sciences, Humanitas University, Pieve Emanuele (MI), Italy; Division of Internal Medicine and Hepatology, Department of Gastroenterology, IRCCS Humanitas Research Hospital, Rozzano (MI), Italy.
² Hepatology Unit, CEMAD Centro Malattie dell'Apparato Digerente, Medicina Interna e Gastroenterologia, Fondazione Policlinico Universitario Gemelli IRCCS, Rome 00168, Italy.
³ Department of Biomedical Sciences, Humanitas University, Pieve Emanuele (MI), Italy.
⁴ Department of Biomedical Sciences, Humanitas University, Pieve Emanuele (MI), Italy; IBD Center, Department of Gastroenterology, IRCCS Humanitas Research Hospital, Rozzano (MI), Italy.
⁵ Hepatology Unit, CEMAD Centro Malattie dell'Apparato Digerente, Medicina Interna e Gastroenterologia, Fondazione Policlinico Universitario Gemelli IRCCS, Rome 00168, Italy; Dipartimento di Medicina e Chirurgia Traslazionale, Università Cattolica del Sacro Cuore, Rome 00168, Italy.
⁶ Department of Biomedical Sciences, Humanitas University, Pieve Emanuele (MI), Italy; Division of Internal Medicine and Hepatology, Department of Gastroenterology, IRCCS Humanitas Research Hospital, Rozzano (MI), Italy. Electronic address: alessio.aghemo@hunimed.eu.

PMID: 38044225
DOI: 10.1016/j.dld.2023.11.021

Abstract

Porto-sinusoidal vascular disorder (PSVD) encompasses a group of vascular disorders characterized by lesions involving the portal venules and sinusoids, independent of the presence of portal hypertension (PH), and for which liver biopsy is essential for diagnosis. PSVD has been shown to be common in patients with immune-mediated diseases, including inflammatory bowel disease (IBD). The association between PSVD and the use of thiopurines and thioguanine in patients with IBD has been well established. In addition, research suggests an association between PSVD and IBD, even in cases where patients haven't been exposed to specific medications, probably related to changes in intestinal permeability. The identification and management of patients with known IBD and PSVD is a challenge for gastroenterologists. This narrative review aims to summarize the currently available data on the association between IBD and PSVD and provide practical suggestions for the management of this group of patients.

Keywords: Inflammatory bowel disease (IBD); Nodular regenerative hyperplasia (NRH); Portal hypertension (PH); Porto-sinusoidal vascular disorder (PSVD).

Publication types

Review