Brief Articles
Copyright ©2009 The WJG Press and Baishideng. All rights reserved.
World J Gastroenterol. Jul 7, 2009; 15(25): 3128-3133
Published online Jul 7, 2009. doi: 10.3748/wjg.15.3128
Portal hypertension secondary to myelofibrosis with myeloid metaplasia: A study of 13 cases
Mohannad Abu-Hilal, Jayant Tawaker
Mohannad Abu-Hilal, Jayant Tawaker, Department of Internal Medicine, Division of Gastroenterology, Mayo Clinic College of Medicine, Rochester, MN 55902, United States
Author contributions: Abu-Hilal M collected and analyzed data and prepared the first draft; Tawaker J designed the research project and edited the first draft; Abu-Hilal M wrote the final manuscript.
Correspondence to: Mohannad Abu-Hilal, MD, Department of Internal Medicine, Division of Gastroenterology, Mayo Clinic College of Medicine, 911 41st Street NW, Rochester, MN 55902, United States.
Telephone: +1-507-2618399
Fax: +1-507-2618399
Received: April 9, 2009
Revised: May 9, 2009
Accepted: May 16, 2009
Published online: July 7, 2009

AIM: To describe the clinical presentation and complications of portal hypertension (PH) secondary to myelofibrosis with myeloid metaplasia (MMM).

METHODS: Medical records for 123 patients with MMM were reviewed.

RESULTS: Thirteen patients with PH secondary to MMM were identified. Median ages at time of MMM and PH diagnosis were 61 and 66 years, respectively. The interval from MMM diagnosis to presentation with one of the PH features ranged from 1 to 11 years. Variceal bleeding and ascites were the most common presentations. Of the eight patients who presented with variceal bleeding, six patients underwent endoscopic variceal ligation (EVL) with no variceal recurrence or hematological worsening during a 12-mo follow up period.

CONCLUSION: Patients with MMM might develop PH. Exact mechanisms leading to PH in MMM are still controversial. As in other etiologies, variceal bleeding and ascites are the most common presentations. Anemia may correlate with, and/or predict, the severity of the PH presentation in these patients. EVL can successfully control variceal bleeding in MMM. Further clinical studies are required.

Keywords: Portal hypertension, Myelofibrosis, Myeloid metaplasia, Ascites, Variceal bleeding