1.Research advances in the early predictive factors for non-neoplastic portal vein thrombosis in liver cirrhosis
Zunlan ZHOU ; Lina YANG ; Qingqing LI ; Hong WANG
Journal of Clinical Hepatology 2022;38(9):2150-2154
Portal vein thrombosis (PVT) is one of the common complications in patients with decompensated liver cirrhosis, including non-neoplastic PVT and portal vein tumor thrombus after the onset of primary liver cancer. It can lead to the deterioration of liver function, aggravate the portal hypertension-related adverse events including esophagogastric variceal bleeding, reduce the survival rate of patients after liver transplantation, and even threaten the life of patients in severe cases. Therefore, it is of great clinical significance to further explore the risk factors and early predictive factors for PVT. This article elaborates on the recent advances in the early predictive factors for non-neoplastic PVT in liver cirrhosis from the aspects of the three elements of thrombosis, the severity of liver injury, and the endoscopic treatment of esophagogastric varices. The analysis of related research shows that some early predictive factors are clearly associated with the formation of PVT, which provides help for the early identification of PVT; however, specific predictive values may be unclear or have certain differences, which needs to be confirmed by multicenter prospective studies.
2.A case of erythrogenic protoporphyria with thyrotoxicosis and liver dysfunction in an adult female
Qingqing LI ; Xiaoyan CHEN ; Hong WANG ; Biguang TUO ; Zunlan ZHOU ; Lina YANG
Journal of Central South University(Medical Sciences) 2023;48(11):1769-1774
Erythropoietic protoporphyria(EPP)is an inherited metabolic disease caused by the deficiency in ferrochelatase(FECH)encoded by the FECH gene,and it is inherited in an autosomal recessive manner.EPP usually produces acute pain photosensitivity after exposure to sunlight in infancy or early childhood,and liver failure is the most serious associated complication.This article reported an adult female case of EPP complicated with thyrotoxicosis and liver dysfunction which is a rare condition.The patient's liver function improved after liver protection treatment,her thyroid function returned to normal,and her EPP symptoms improved significantly.Moreover,the c.286C>T gene mutation may be the pathogenic locus of EPP.For patients with abnormal liver function,the possibility of EPP should be considered after the common causes are excluded,and FECH gene detection should be done to confirm the diagnosis in time.When EPP is associated with thyrotoxicosis and liver dysfunction,priority may be given to hepatoprotective therapy.