Laura Graf1,2, Rucsandra Dobrota1,2, Suzana Jordan1,2, Lukas Martin Wildi1,2, Oliver Distler1,2, Britta Maurer3,4. 1. From the Department of Rheumatology, University Hospital Zurich, Zurich, Switzerland. 2. L. Graf, cand.med., Department of Rheumatology, University Hospital Zurich; R. Dobrota, MD, Department of Rheumatology, University Hospital Zurich; S. Jordan, MD, Department of Rheumatology, University Hospital Zurich; L.M. Wildi, MD, Department of Rheumatology, University Hospital Zurich; O. Distler, MD, Department of Rheumatology, University Hospital Zurich; B. Maurer, MD, Department of Rheumatology, University Hospital Zurich. 3. From the Department of Rheumatology, University Hospital Zurich, Zurich, Switzerland. britta.maurer@usz.ch. 4. L. Graf, cand.med., Department of Rheumatology, University Hospital Zurich; R. Dobrota, MD, Department of Rheumatology, University Hospital Zurich; S. Jordan, MD, Department of Rheumatology, University Hospital Zurich; L.M. Wildi, MD, Department of Rheumatology, University Hospital Zurich; O. Distler, MD, Department of Rheumatology, University Hospital Zurich; B. Maurer, MD, Department of Rheumatology, University Hospital Zurich. britta.maurer@usz.ch.
Abstract
OBJECTIVE: To investigate nodular regenerative hyperplasia (NRH) as a vascular complication of systemic sclerosis (SSc) with microvasculopathy as a common denominator. METHODS: Cases of SSc-NRH were identified by systematic literature review and by screening the Zurich cohort. NRH had to be diagnosed by liver biopsy. RESULTS: Literature review retrieved 22 cases. In our cohort, 1.4% of patients with SSc were diagnosed with NRH. Most had vasculopathy, were positive for anticentromere antibodies, had elevated alkaline phosphatase and gamma-glutamyl transferase levels, normal liver morphology on ultrasound yet increased stiffness on ultrasound elastography, and had portal hypertension. CONCLUSION: NRH might represent a rare yet potentially life-threatening vascular complication in SSc.
OBJECTIVE: To investigate nodular regenerative hyperplasia (NRH) as a vascular complication of systemic sclerosis (SSc) with microvasculopathy as a common denominator. METHODS: Cases of SSc-NRH were identified by systematic literature review and by screening the Zurich cohort. NRH had to be diagnosed by liver biopsy. RESULTS: Literature review retrieved 22 cases. In our cohort, 1.4% of patients with SSc were diagnosed with NRH. Most had vasculopathy, were positive for anticentromere antibodies, had elevated alkaline phosphatase and gamma-glutamyl transferase levels, normal liver morphology on ultrasound yet increased stiffness on ultrasound elastography, and had portal hypertension. CONCLUSION: NRH might represent a rare yet potentially life-threatening vascular complication in SSc.