Nodular regenerative hyperplasia: Difference between revisions
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{{Infobox medical condition | |||
| name = Nodular regenerative hyperplasia | |||
| image = [[File:Gray1085.png|left|thumb|Liver anatomy]] | |||
| caption = Diagram of the liver | |||
| field = [[Hepatology]] | |||
| synonyms = NRH | |||
| symptoms = [[Portal hypertension]], [[splenomegaly]], [[ascites]], [[esophageal varices]] | |||
| complications = [[Liver failure]], [[portal hypertension]] | |||
| onset = Variable | |||
| duration = Chronic | |||
| causes = Unknown, associated with [[autoimmune diseases]], [[hematological disorders]], [[medications]] | |||
| risks = [[Autoimmune diseases]], [[hematological disorders]], certain [[medications]] | |||
| diagnosis = [[Liver biopsy]], [[imaging studies]] | |||
| differential = [[Cirrhosis]], [[hepatic fibrosis]], [[focal nodular hyperplasia]] | |||
| treatment = Symptomatic management, [[portal hypertension]] treatment | |||
| prognosis = Variable, depends on complications | |||
| frequency = Rare | |||
}} | |||
Nodular Regenerative Hyperplasia | Nodular Regenerative Hyperplasia | ||
Nodular Regenerative Hyperplasia (NRH) is a rare liver condition characterized by the diffuse transformation of normal hepatic parenchyma into small regenerative nodules without significant fibrosis. This condition can lead to non-cirrhotic portal hypertension and is often associated with various systemic diseases and medications. | Nodular Regenerative Hyperplasia (NRH) is a rare liver condition characterized by the diffuse transformation of normal hepatic parenchyma into small regenerative nodules without significant fibrosis. This condition can lead to non-cirrhotic portal hypertension and is often associated with various systemic diseases and medications. | ||
==Pathophysiology== | ==Pathophysiology== | ||
NRH is believed to result from uneven blood flow within the liver, leading to atrophy of some hepatocytes and compensatory hyperplasia of others, forming nodules. Unlike cirrhosis, NRH does not involve significant fibrosis, which distinguishes it from other nodular liver diseases. | NRH is believed to result from uneven blood flow within the liver, leading to atrophy of some hepatocytes and compensatory hyperplasia of others, forming nodules. Unlike cirrhosis, NRH does not involve significant fibrosis, which distinguishes it from other nodular liver diseases. | ||
==Causes== | ==Causes== | ||
The exact cause of NRH is unknown, but it is associated with several conditions and factors, including: | The exact cause of NRH is unknown, but it is associated with several conditions and factors, including: | ||
* [[Autoimmune diseases]] such as [[systemic lupus erythematosus]] and [[rheumatoid arthritis]]. | * [[Autoimmune diseases]] such as [[systemic lupus erythematosus]] and [[rheumatoid arthritis]]. | ||
* [[Hematological disorders]] like [[myeloproliferative neoplasms]]. | * [[Hematological disorders]] like [[myeloproliferative neoplasms]]. | ||
* Use of certain medications, including [[chemotherapy]] agents and [[immunosuppressants]]. | * Use of certain medications, including [[chemotherapy]] agents and [[immunosuppressants]]. | ||
* [[HIV/AIDS]] and other chronic infections. | * [[HIV/AIDS]] and other chronic infections. | ||
==Clinical Presentation== | ==Clinical Presentation== | ||
Patients with NRH may be asymptomatic or present with signs of portal hypertension, such as: | Patients with NRH may be asymptomatic or present with signs of portal hypertension, such as: | ||
* [[Splenomegaly]] | * [[Splenomegaly]] | ||
* [[Esophageal varices]] | * [[Esophageal varices]] | ||
* [[Ascites]] | * [[Ascites]] | ||
* [[Hepatic encephalopathy]] | * [[Hepatic encephalopathy]] | ||
==Diagnosis== | ==Diagnosis== | ||
The diagnosis of NRH is challenging and often requires a combination of clinical, laboratory, and imaging studies. A definitive diagnosis is usually made through a liver biopsy, which shows nodular transformation without significant fibrosis. | The diagnosis of NRH is challenging and often requires a combination of clinical, laboratory, and imaging studies. A definitive diagnosis is usually made through a liver biopsy, which shows nodular transformation without significant fibrosis. | ||
===Imaging=== | ===Imaging=== | ||
Imaging studies such as [[ultrasound]], [[CT scan]], and [[MRI]] may show nodular liver surface and signs of portal hypertension but are not specific for NRH. | Imaging studies such as [[ultrasound]], [[CT scan]], and [[MRI]] may show nodular liver surface and signs of portal hypertension but are not specific for NRH. | ||
===Histology=== | ===Histology=== | ||
Liver biopsy is the gold standard for diagnosis, revealing nodular regenerative changes in the absence of fibrosis. | Liver biopsy is the gold standard for diagnosis, revealing nodular regenerative changes in the absence of fibrosis. | ||
==Treatment== | ==Treatment== | ||
There is no specific treatment for NRH. Management focuses on treating the underlying condition and complications of portal hypertension. This may include: | There is no specific treatment for NRH. Management focuses on treating the underlying condition and complications of portal hypertension. This may include: | ||
* [[Beta-blockers]] for variceal bleeding prevention. | * [[Beta-blockers]] for variceal bleeding prevention. | ||
* [[Diuretics]] for ascites management. | * [[Diuretics]] for ascites management. | ||
* [[Endoscopic]] interventions for variceal bleeding. | * [[Endoscopic]] interventions for variceal bleeding. | ||
==Prognosis== | ==Prognosis== | ||
The prognosis of NRH varies depending on the underlying cause and the presence of complications. Patients with well-controlled underlying conditions and minimal portal hypertension may have a favorable outcome. | The prognosis of NRH varies depending on the underlying cause and the presence of complications. Patients with well-controlled underlying conditions and minimal portal hypertension may have a favorable outcome. | ||
==See Also== | ==See Also== | ||
* [[Portal hypertension]] | * [[Portal hypertension]] | ||
* [[Liver cirrhosis]] | * [[Liver cirrhosis]] | ||
* [[Hepatology]] | * [[Hepatology]] | ||
==External Links== | ==External Links== | ||
* [American Liver Foundation](https://www.liverfoundation.org) | * [American Liver Foundation](https://www.liverfoundation.org) | ||
* [National Institute of Diabetes and Digestive and Kidney Diseases](https://www.niddk.nih.gov) | * [National Institute of Diabetes and Digestive and Kidney Diseases](https://www.niddk.nih.gov) | ||
{{Liver diseases}} | {{Liver diseases}} | ||
{{Portal hypertension}} | {{Portal hypertension}} | ||
[[Category:Liver diseases]] | [[Category:Liver diseases]] | ||
[[Category:Hepatology]] | [[Category:Hepatology]] | ||
[[Category:Rare diseases]] | [[Category:Rare diseases]] | ||
Latest revision as of 22:16, 6 April 2025
Editor-In-Chief: Prab R Tumpati, MD
Obesity, Sleep & Internal medicine
Founder, WikiMD Wellnesspedia &
W8MD medical weight loss NYC and sleep center NYC
| Nodular regenerative hyperplasia | |
|---|---|
 | |
| Synonyms | NRH |
| Pronounce | N/A |
| Specialty | N/A |
| Symptoms | Portal hypertension, splenomegaly, ascites, esophageal varices |
| Complications | Liver failure, portal hypertension |
| Onset | Variable |
| Duration | Chronic |
| Types | N/A |
| Causes | Unknown, associated with autoimmune diseases, hematological disorders, medications |
| Risks | Autoimmune diseases, hematological disorders, certain medications |
| Diagnosis | Liver biopsy, imaging studies |
| Differential diagnosis | Cirrhosis, hepatic fibrosis, focal nodular hyperplasia |
| Prevention | N/A |
| Treatment | Symptomatic management, portal hypertension treatment |
| Medication | N/A |
| Prognosis | Variable, depends on complications |
| Frequency | Rare |
| Deaths | N/A |
Nodular Regenerative Hyperplasia
Nodular Regenerative Hyperplasia (NRH) is a rare liver condition characterized by the diffuse transformation of normal hepatic parenchyma into small regenerative nodules without significant fibrosis. This condition can lead to non-cirrhotic portal hypertension and is often associated with various systemic diseases and medications.
Pathophysiology[edit]
NRH is believed to result from uneven blood flow within the liver, leading to atrophy of some hepatocytes and compensatory hyperplasia of others, forming nodules. Unlike cirrhosis, NRH does not involve significant fibrosis, which distinguishes it from other nodular liver diseases.
Causes[edit]
The exact cause of NRH is unknown, but it is associated with several conditions and factors, including:
- Autoimmune diseases such as systemic lupus erythematosus and rheumatoid arthritis.
- Hematological disorders like myeloproliferative neoplasms.
- Use of certain medications, including chemotherapy agents and immunosuppressants.
- HIV/AIDS and other chronic infections.
Clinical Presentation[edit]
Patients with NRH may be asymptomatic or present with signs of portal hypertension, such as:
Diagnosis[edit]
The diagnosis of NRH is challenging and often requires a combination of clinical, laboratory, and imaging studies. A definitive diagnosis is usually made through a liver biopsy, which shows nodular transformation without significant fibrosis.
Imaging[edit]
Imaging studies such as ultrasound, CT scan, and MRI may show nodular liver surface and signs of portal hypertension but are not specific for NRH.
Histology[edit]
Liver biopsy is the gold standard for diagnosis, revealing nodular regenerative changes in the absence of fibrosis.
Treatment[edit]
There is no specific treatment for NRH. Management focuses on treating the underlying condition and complications of portal hypertension. This may include:
- Beta-blockers for variceal bleeding prevention.
- Diuretics for ascites management.
- Endoscopic interventions for variceal bleeding.
Prognosis[edit]
The prognosis of NRH varies depending on the underlying cause and the presence of complications. Patients with well-controlled underlying conditions and minimal portal hypertension may have a favorable outcome.
See Also[edit]
External Links[edit]
- [American Liver Foundation](https://www.liverfoundation.org)
- [National Institute of Diabetes and Digestive and Kidney Diseases](https://www.niddk.nih.gov)
| Liver diseases | ||||||||||
|---|---|---|---|---|---|---|---|---|---|---|
This liver disease related article is a stub.
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