Arab J Gastroenterol
· 2025 May · PMID 40328562
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BACKGROUND: Intestinal metaplasia (IM) is a significant gastric mucosal change that warrants attention due to its potential role in the pathogenesis of gastric cancer. IM is often triggered by Helicobacter pylori (H. pyl...BACKGROUND: Intestinal metaplasia (IM) is a significant gastric mucosal change that warrants attention due to its potential role in the pathogenesis of gastric cancer. IM is often triggered by Helicobacter pylori (H. pylori) infection and some risk factors. PATIENTS AND METHODS: This study examined H. pylori infection and related risk factors in 7,096 participants, identifying 2,200 cases of IM linked to H. pylori and 4,896 controls without the infection in Wuwei, Gansu Province, China. The Operative Link on Gastritis/Intestinal Metaplasia (OLGIM) and (Operative Link on Gastritis Assessment (OLGA) classifications tools were used for identifying participants at high risk for gastric cancer by evaluating the severity and extent of H. pylori infection and IM. RESULTS: The study found that IM and H. pylori prevalence were gender-related, with males representing 41.09 % of cases compared to 33.92 % of controls, a significant difference (P < 0.0001). Conversely, females were more prevalent in the control group (66.07 %) compared to the case group (58.91 %). Age analysis showed higher proportions of IM cases in the 40-49 years group (46.95 %) compared to controls (43.40 %), with significant differences across age groups (P < 0.0001). IM showed significant positive correlations with smoking , alcohol consumption , and drinking water sources . H. pylori infection was detected in 238 (10.81 %) of the case group and 542 (11.07 %) of the control group. Using the OLGIM classification, which incorporates IM into gastric cancer risk assessment, stage 0 (no IM) was observed in 1,189 (24.28 %) of the control group and 530 (24.09 %) of the case group. Stage 1 (mild IM) was found in 3,165 (64.62 %) of the controls and 1,432 (65.09 %) of the cases. Stage 2 (moderate IM) was present in 520 (10.62 %) of the controls and 220 (10 %) of the cases, while stage 3 (severe IM) was observed in 24 (0.49 %) of the controls and 18 (0.82 %) of the cases. For OLGA staging, the case group had a higher percentage of individuals in higher stages (III and IV) compared to the control group. Specifically, 50.84 % of the cases were classified as stage 0, 19.75 % , stage I, 14.71 %, stage II, 8.40 %, stage III, and IV, 6.30 %. In the control group, 54.43 % were classified as stage 0, 24.17 %, stage I, 18.45 %, stage II, 1.66 %, stage III, and IV, 1.29 % respectively. CONCLUSIONS: These findings suggest that older individuals, males, smokers, drinkers, and those using certain drinking water sources are more likely to develop IM. The study highlights the combined impact of H. pylori and risk factors on IM development, emphasizing the need for comprehensive public health strategies to address these risks. The higher proportion of advanced OLGA stages in the case group suggests more severe gastric atrophy, potentially indicating a higher risk for gastric cancer development.
Arab J Gastroenterol
· 2025 Feb · PMID 39880724
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Access to advanced medical procedures, such as gastrointestinal (GI) endoscopy, is critical for effective healthcare. In Sub-Saharan Africa, including Sudan, GI endoscopy services remain limited, posing significant barri...Access to advanced medical procedures, such as gastrointestinal (GI) endoscopy, is critical for effective healthcare. In Sub-Saharan Africa, including Sudan, GI endoscopy services remain limited, posing significant barriers to early diagnosis and treatment of GI diseases. Expanding GI endoscopy services in Sudan and other regions of Sub-Saharan Africa is crucial to improve early detection, reduce mortality, and increase the cost-effectiveness of healthcare delivery. This letter reviews the current state of GI endoscopy in Sudan, highlights the importance of enhancing this service, and proposes how the British Society of Gastroenterology (BSG) could assist in improving accessibility and quality.
Arab J Gastroenterol
· 2025 Feb · PMID 39880723
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BACKGROUND AND STUDY AIMS: Non-alcoholic fatty liver disease (NAFLD) is the most prevalent chronic liver disorder, affecting 23% to 32% of the global population. This clinical study aimed to assess the efficacy of Curcum...BACKGROUND AND STUDY AIMS: Non-alcoholic fatty liver disease (NAFLD) is the most prevalent chronic liver disorder, affecting 23% to 32% of the global population. This clinical study aimed to assess the efficacy of Curcuma zedoaria Rosc. compared to vitamin E in managing NAFLD. PATIENTS AND METHODS: In this randomized, single-blind, standard-controlled study, 68 patients with grade 1 (mild) and grade 2 (moderate) NAFLD were randomly assigned to receive either Curcuma zedoaria Rosc. powder in capsule form (500 mg orally, twice a day) in the test group or vitamin E (400 mg orally, twice a day) in the control group for 60 days. Secondary endpoints included improvements in fatty liver grades, ultra-sonographic liver span, lipid profile, and liver function parameters after 60 days. Primary endpoints included improvements in dull ache intensity in the right hypochondrium (RHC), dyspepsia, anorexia, and severity of malaise assessed at days 0, 15, 30, 45, and 61. RESULTS: Per protocol analysis was performed on 50 patients who completed the study. Both test and control groups showed significant improvement in dull ache severity in the RHC (p < 0.0001). The test group exhibited more favorable outcomes post-treatment (Chi-sq = 23.17, df = 2, p < 0.0001). Dyspepsia severity significantly improved in both groups post-treatment (p = 0.005 and p = 0.010, respectively), with the test group showing slightly better outcomes. Anorexia significantly improved in the test group (p = 0.016) from 72.00 % reporting absence post-treatment to 100.00 % absence, while the control group showed improvement without statistical significance (p = 0.102). Malaise severity significantly improved in the test group (p < 0.0001), with 84.00 % reporting absence post-treatment compared to 8.00 % in the control group, showing significant differences (p < 0.0001). Both groups exhibited a significant reduction in liver span post-treatment (p-value < 0.0001) without inter- group differences. Fatty liver grades improved significantly in both groups post-treatment (p < 0.0001), with no significant difference between groups (Chi-sq = 4, df = 2, p = 0.1353). There were no changes in liver function markers and lipid parameters in both groups, though the test drug demonstrated a slight reduction in serum triglyceride levels. No drug-related adverse events were observed during the trial. CONCLUSION: The study revealed that Curcuma zedoaria Rosc. is effective in managing NAFLD, showing better outcomes than vitamin E in subjective parameters like dyspepsia, malaise, anorexia, and dull ache in RHC. With no observed drug-related adverse events, Curcuma zedoaria Rosc. could be a suitable alternative to conventional treatment modalities for NAFLD.
Fouad R, El-Akel W, ElMakhzangy H
… +6 more, Lithy RM, Sherif M, Fateen M, Hassany M, Abdel-Razek W, Doss W
Arab J Gastroenterol
· 2025 Feb · PMID 39875290
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BACKGROUND AND STUDY AIMS: Hepatitis C virus (HCV) infection is a significant problem in Egypt, as it is associated with various hematological disorders, both benign and malignant. In Egypt, direct-acting antivirals (DAA...BACKGROUND AND STUDY AIMS: Hepatitis C virus (HCV) infection is a significant problem in Egypt, as it is associated with various hematological disorders, both benign and malignant. In Egypt, direct-acting antivirals (DAAs) serve as the principal therapy for HCV to achieve a sustained virological response (SVR). This study investigated the effects of sofosbuvir (SOF) and daclatasvir (DCV) on HCV patients with benign blood index abnormalities and examined the correlation between these abnormalities and SVR. PATIENTS AND METHODS: Data were obtained from 59,069 enrolled patients who were treatment-naïve and met the eligibility criteria for therapy as per the standards of Egypt's National Committee for Control of Viral Hepatitis (NCCVH). The patients adhered to the SOF and DCV therapy protocol. RESULTS: The predominant hematological abnormality was thrombocytopenia, followed by leukopenia and anemia. Non-SVR was significantly correlated with the existence of one or more baseline cytopenias. The primary predictors of treatment failure were male gender, elevated Fib-4 score, and baseline thrombocytopenia. Despite the low incidence of cytopenia among patients after therapy, non-SVR was seen in instances of anemia. CONCLUSION: Hematological problems often occur in HCV patients both before and after SOF and DCV treatment. Treatment failure was associated with the presence of one or more baseline cytopenias, as well as the development of anemia during treatment. Nonetheless, SOF and DCV are still safe to be used in the presence of cytopenia.
Gao C, Feng Z, Wang L
… +4 more, Fu K, Yang Z, Wang S, Yu S
Arab J Gastroenterol
· 2025 Feb · PMID 39818482
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BACKGROUND AND STUDY AIMS: Necrotizing enterocolitis (NEC) is a severe gastrointestinal disease in neonates. In vitro model is an indispensable tool to study the pathogenesis of NEC. This study explored the effects of di...BACKGROUND AND STUDY AIMS: Necrotizing enterocolitis (NEC) is a severe gastrointestinal disease in neonates. In vitro model is an indispensable tool to study the pathogenesis of NEC. This study explored the effects of different stress factors on intestinal injury in vitro. MATERIAL AND METHODS: Rat intestinal epithelial cell line-6 (IEC-6) cells were exposed to different stressors, including lipopolysaccharide (LPS), cobalt chloride (CoCl), and a combination of both. We estimated the cell viability, the expression of inflammatory cytokines and tight junction proteins. RESULTS: The decrease in IEC-6 cell viability was observed after stimulation by CoCl alone or in combination with LPS, but not after stimulation with LPS alone. The expression of interleukin6 (IL-6) and tumornecrosisfactoralpha (TNFα) increased in each group. After stimulation with CoCl alone or in combination with LPS, a decrease in Claudin-1 was observed, but an increase was detected after stimulation with LPS alone. Zona occludens 1 (ZO-1) decreased in both mRNA and protein levels after combined stimulation. CONCLUSION: The combined stimulation of LPS and CoCl on IEC-6 cells could simultaneously induce severe inflammation and barrier damage, which may better simulate the pathological process of NEC.
Shousha HI, Barakat EMF, Rewisha E
… +27 more, El-Kassas M, Moustafa EF, Said M, Abdelaziz AO, Askar SR, Elkhateeb E, Tawheed A, Abdelmalek MO, Ramadan A, Abdelmaksoud AH, Alfattah Shamkh MA, Sayed H, Riad AR, Nassief A, Nabeel MM, Abdelrazek YA, Abdeen N, Elbaz T, Sayed SA, Eldaly U, Lithy R, Abdelaziz AA, Hashem MB, Niazi G, Abo-Elazm OM, Kohla M, Egyptian Network for the Study of HCC (ENSH) group
Arab J Gastroenterol
· 2025 Feb · PMID 39794187
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BACKGROUND AND STUDY AIMS: Few studies have considered patients treated with trans-arterial chemoembolization (TACE) for non-viral-induced hepatocellular carcinoma (HCC), with some reporting that those patients may have...BACKGROUND AND STUDY AIMS: Few studies have considered patients treated with trans-arterial chemoembolization (TACE) for non-viral-induced hepatocellular carcinoma (HCC), with some reporting that those patients may have larger tumors, emphasizing the need for determination of the factors affecting survival in such patients. This work aims to study the characteristics and survival of patients with non-viral related HCC treated with TACE. PATIENTS AND METHODS: This is a multicenter observational study. Patients (166) with non-viral related HCC treated with TACE were recruited from six tertiary care centers (January 2008- June 2022). Follow-up continued until death or the end of the study (August 2023). RESULTS: The patients had a mean age of 60.2 ± 9.5 years, a male predominance of 79.5 %. The mean size of the lesions was 5.71 ± 3.02 cm, and 42.8 % of the patients had a single lesion. After a median follow-up period of 27.02 months (IQR 14.99-39.37), the median overall survival (OS) was 42.14 months. The Cox regression hazard model revealed that the independent factors affecting survival were: multiple focal lesions, exceeding five in number, have a substantially higher hazard of death (HR = 8.5, p-value = 0.001) compared to those with a single focal lesion. HAP score grade D exhibited a threefold increase in the hazard of death (HR = 3.8, p-value 0.007). Individuals who did not respond positively to treatment faced a significantly higher risk of death (HR = 10.76, p-value 0.001). Albumin-bilirubin score (ALBI), Easy ALBI, platelet albumin (PAL), platelet albumin bilirubin score (PALBI), The hepatoma arterial-embolisation (HAP) and Tumor burden score were found not to impact the survival of our patients. CONCLUSION: Tumor burden is an important determinant of survival after TACE in patients with non-viral HCC. HAP score can be implemented in selecting patients who would benefit from TACE.
Hou JP, Yang LY, Liu LB
… +3 more, Han EK, Han CQ, Yang LP
Arab J Gastroenterol
· 2025 Feb · PMID 39765392
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BACKGROUND AND STUDY AIMS: This study was aimed to validate the correlation of circular RNA HIPK3 (CircHIPK3) expression in serum and tissues with the progression of liver fibrosis (LF) and liver cirrhosis (LC). PATIENTS...BACKGROUND AND STUDY AIMS: This study was aimed to validate the correlation of circular RNA HIPK3 (CircHIPK3) expression in serum and tissues with the progression of liver fibrosis (LF) and liver cirrhosis (LC). PATIENTS AND METHODS: Serum CircHIPK3 expressions were detected in 120 patients with LF/LC and 120 healthy controls (HCs). CircHIPK3 expression in tissues was detected in 120 fibrotic liver tissues and compared to 57 healthy liver tissues from patients with hepatic hemangioma. The expressions of CircHIPK3, TGF-β1, and CollA1 mRNAs were assessed by qRT-PCR. The Child-Pugh (CP) classification was used to evaluate disease severity. The Ishak score was applied to assess LF/LC in liver biopsy samples. The levels of serum alanine aminotransferase (ALT) and aspartate aminotransferase (AST) were also investigated. Receiver operating characteristic (ROC) analysis was conducted to assess the diagnostic value of CircHIPK3 expressions in serum and tissues. RESULTS: CircHIPK3 expressions in serum and tissues were upregulated in patients with LF/LC compared to HCs. The patient group comprised 39 with CP class A (CP-A), 45 with CP class B (CP-B), and 36 with CP class B (CP-C). Patients with CP-C had markedly increased serum and local CircHIPK3 levels compared to those with CP-B and CP-A. Patients with CP-B showed upregulated CircHIPK3 expressions in serum and tissues compared to CP-A with statistical significance. ROC curve analysis indicated that CircHIPK3 expressions in both serum and tissues may serve as potential diagnostic indicators for the progression of LF/LC. Moreover, serum CircHIPK3 expressions were positively associated with serum ALT and AST levels. Tissue CircHIPK3 expressions were positively correlated with tissue TGF-β1 and CollA1 mRNA expressions. In addition, both serum and tissue CircHIPK3 expressions were positively associated with the Ishak score. CONCLUSIONS: For the first time, this study demonstrated the positive correlation of CircHIPK3 expressions in both serum and tissues with the progression of LF/LC, regardless of etiology. CircHIPK3 might play a significant role in the development of LF/LC and act as a potential therapeutic target for these conditions.
Arab J Gastroenterol
· 2025 Feb · PMID 39765391
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BACKGROUND AND STUDY AIMS: Hirschsprung disease (HD) is a complex developmental disease that resulted from impaired proliferation and migration of neural crest cells. Despite the genetic causation of enteric nervous syst...BACKGROUND AND STUDY AIMS: Hirschsprung disease (HD) is a complex developmental disease that resulted from impaired proliferation and migration of neural crest cells. Despite the genetic causation of enteric nervous system have been found to be responsible for part of HD cases, the genetic aetiology of most HD patients still needs to be explored. PATIENTS AND METHODS: Whole-genome sequencing and subsequent Sanger sequencing validation analysis were performed in 13 HD children and their unaffected parents. Autophagy assays were performed to validate the functions of the identified locus. RESULTS: After the initial quality checking (SNP quality score ≥ 40, coverage ≥ 10X) of the raw data, we identified 3182 single nucleotide variants (SNVs). We subsequently compared these SNVs against the public databases and got a total of 15 suspicious genes shared among these patients. Subsequent Sanger sequencing and bioinformatics analyses revealed that amino acid-altering de novo mutation c.1648C > T(p.L550F) in ALK was responsible for HD. For validation, we sequenced all 29 exons ofALKin 76 additional sporadic HD cases and 200 healthy children and identified this variant in five of the HD cases. We further illustrated that ALK mutation c.1648C > T interrupted the interactions between ALK and its ligand midkine (Mdk), and induced autophagic cell death through AKT/mTORC1 axis. CONCLUSION: These finding implied that the abnormal variant of ALK c.1648C > T may account for the pathogenesis of HD.
Ramadan A, Kaddah M, Shousha H
… +1 more, El-Kassas M
Arab J Gastroenterol
· 2025 Feb · PMID 39765390
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Personalized medicine is an emerging field that provides novel approaches to disease's early diagnosis, prevention, treatment, and prognosis based on the patient's criteria in gene expression, environmental factors, life...Personalized medicine is an emerging field that provides novel approaches to disease's early diagnosis, prevention, treatment, and prognosis based on the patient's criteria in gene expression, environmental factors, lifestyle, and diet. To date, hepatocellular carcinoma (HCC) is a significant global health burden, with an increasing incidence and significant death rates, despite advancements in surveillance, diagnosis, and therapeutic approaches. The majority of HCC lesions develop in patients with liver cirrhosis, carrying the risks of mortality associated with both the tumor burden and the cirrhosis. New therapeutic agents involving immune checkpoint inhibitors and targeted agents have been developed for sequential or concomitant application for advanced HCC but only a tiny percentage of patients benefit from each approach. Moreover, clinicians encounter difficulties determining the most appropriate regimen for each patient. This emphasizes the need for a personalized treatment approach. In other words, patients should no longer undergo treatment based on their tumor's histology but depending on the distinct molecular targets specific to their tumor biology. However, the utilization of precision medicine in managing HCC is still challenging. This review aims to discuss the role of personalized medicine in diagnosing, managing, and defining the prognosis of HCC. We also discuss the role of liquid biopsy and their clinical applications for immunotherapies in HCC. More clinical studies are still necessary to improve the precision of biomarkers used in the treatment decision for patients with HCC.
Li M, Chen T, Huang R
… +4 more, Cen Y, Zhao F, Fan R, He G
Arab J Gastroenterol
· 2025 Feb · PMID 39757079
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BACKGROUND AND STUDY AIMS: As a novel immunotherapy, chimeric antigen receptor T (CAR-T) cell technology is successful in treating hematologic malignancies, and exhibits potential benefits in partial solid tumors. Therap...BACKGROUND AND STUDY AIMS: As a novel immunotherapy, chimeric antigen receptor T (CAR-T) cell technology is successful in treating hematologic malignancies, and exhibits potential benefits in partial solid tumors. Therapies targeting one antigen have some weaknesses, and dual-targeted CAR-T cells may be a better option. Alpha-fetoprotein (AFP) and glypican-3 (GPC3) are both highly expressed in hepatocellular carcinoma (HCC) and serve as important markers. Our study aimed to compare the cytotoxicity effect of AFP and GPC3 dual-targeted CAR-T cells on HCC cells in vitro and its therapeutic effects on a SCID xenograft model with those of single-targeted CAR-T cells. MATERIALS AND METHODS: pLVX lentivirus vectors loaded with AFP CAR, GPC3 CAR, or AFP-GPC3 CAR constructs were transfected into human T lymphocytes. Control T, AFP CAR-T, GPC3 CAR-T, and AFP-GPC3 CAR-T cells were used as effector cells, and HLE (AFPGPC3), Sh-GPC3-Huh-7 (AFP), Sh-AFP-Huh-7 (GPC3), and Huh-7 (AFPGPC3) cells were used as target cells. After their co-culture for 6 h, the LDH cytotoxicity assay was employed to estimate the cell-killing effects of CAR-T cells on the target HCC cells. SCID mice bearing Huh-7 cell-derived neoplasms were injected with CAR-T cells, after which the pathological changes, CD3ζ expression, and IL-2 and IFN-γ levels in mouse tumor tissues were determined. RESULTS: AFP and GPC3 were highly expressed in Huh-7 cells. AFP-GPC3 CAR-T cells exerted significant cell-killing effects on the HCC cells that expressed specific targeting antigen molecules (AFP and GPC3). Besides, AFP-GPC3 CAR-T cells better promoted Th cytokine secretion by Huh-7 cells than AFP CAR-T and GPC3 CAR-T cells. In vivo results suggested that AFP-GPC3 CAR-T cells better inhibited the growth of Huh-7 cell (AFPGPC3)-derived neoplasms than AFP CAR-T and GPC3 CAR-T cells. CONCLUSION: AFP and GPC3 dual-targeted CAR-T cells showed better anti-tumor effects in HCC than AFP or GPC3 single-targeted CAR-T cells.
Arab J Gastroenterol
· 2025 Feb · PMID 39757078
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BACKGROUND AND STUDY AIMS: Nicotinamide N-methyltransferase (NNMT) is aberrantly expressed in tumors and is implicated in the progression and chemoresistance of cancers. This project attempts to explore the specific mole...BACKGROUND AND STUDY AIMS: Nicotinamide N-methyltransferase (NNMT) is aberrantly expressed in tumors and is implicated in the progression and chemoresistance of cancers. This project attempts to explore the specific molecular mechanism by which NNMT enhances 5-fluorouracil (5-FU) resistance in gastric cancer (GC). MATERIALS AND METHODS: By bioinformatics analysis, the expression of NNMT in GC was analyzed and its relationship with patients' prognoses was examined. The signaling pathway enriched by NNMT was analyzed by the Kyoto Encyclopedia of Genes and Genomes (KEGG). Western blot (WB) and quantitative reverse transcription polymerase chain reaction (qRT-PCR) were employed to measure the mRNA and protein expression of NNMT in normal gastric epithelial cells and GC cells. CCK8 was employed to measure cell viability and the IC of 5-FU. The apoptosis rate was assessed by Flow cytometry. WB measured the protein expression of Ki67, epithelial-mesenchymal transition (EMT)-related proteins, PI3K, AKT, p-AKT, NNMT, and H3K9me3. We applied the Transwell assay to measure cell migration and invasion ability. The content of S-adenosylmethionine (SAM) and S-adenosyl-L-homocysteine (SAH) in cells was measured by enzyme-linked immunosorbent assay (ELISA). RESULT: NNMT was greatly upregulated in GC tissues and cells, exhibiting a negative linkage with patients' prognoses. Knocking down NNMT remarkably repressed the vitality, proliferation, anti-apoptotic ability, migration, and invasion of GC cells but elevated the sensitivity of cancer cells to 5-FU. However, overexpression of NNMT inhibited H3K9 methylation by reducing the universal methyl donor SAM, activated the PI3K/AKT pathway, facilitated GC malignant progression, and triggered resistance to 5-FU. CONCLUSION: Upregulation of NNMT expression in GC cells can induce 5-FU resistance by repressing the activation of PI3K/AKT through the inhibition of histone methylation.
Hajj Ali A, Ibrahim MA, Alrazim A
… +1 more, Shaib Y
Arab J Gastroenterol
· 2025 Feb · PMID 39757077
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BACKGROUND: Mucosa-Associated Lymphoid Tissue (MALT) lymphoma or MALToma is a type of non-Hodgkin lymphoma arising in the gastric mucosa that has largely been associated with Helicobacter pylori (H. pylori) infection. Ho...BACKGROUND: Mucosa-Associated Lymphoid Tissue (MALT) lymphoma or MALToma is a type of non-Hodgkin lymphoma arising in the gastric mucosa that has largely been associated with Helicobacter pylori (H. pylori) infection. However, less than 10% of gastric MALTomas can occur with a negative H. pylori status, and the disease seems to have a different course. PATIENTS AND METHODS: Patients diagnosed with MALToma from 2000 to 2021 were included in the study. H. pylori-negative (HPN) status was confirmed when patients had at least 2 negative tests among the following: urea breath test, rapid urease test, serological test, or histology. The patients were divided into H. pylori positive (HPP) and HPN groups. RESULTS: The final analysis included 52 gastric MALToma patients, 25 (48.1 %) were HPN. Demographics and disease stages were comparable between the two groups, although a higher prevalence of HPN cases emerged in patients diagnosed from 2011 to 2021 compared to the 2000-2010 period (55.3 % vs. 28.6 %, p = 0.09). All patients in the HPP group received eradication therapy (ET) compared to only 40 % in the HPN group. ET success in the stage 1 HPN group was 25 % compared to 78.6 % in the HPP group (p = 0.03). More patients in the HPN group received chemo and/or radiotherapy compared to the HPP (86.4 % vs 57.1 %, p = 0.033). Treatment outcomes were similar between both groups. Comparing stage 1 MALToma patients who responded to ET versus non-responders revealed that responders were more likely to be HPP (76.8 % vs. 33.3 %, p = 0.026) and diagnosed in the earlier period (2000-2010, p = 0.048). CONCLUSION: HPN MALToma patients were similar to HPP patients in clinical features. However, there was an increase in diagnosis of HPN MALToma and a decrease in response to ET in more recent years.
Arab J Gastroenterol
· 2025 Feb · PMID 39755497
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Congenital extrahepatic portosystemic shunt, also known as Abernethy malformation, is a rare anatomic vascular malformation. Patients with Abernethy malformation may present with abdominal pain, abnormal liver function t...Congenital extrahepatic portosystemic shunt, also known as Abernethy malformation, is a rare anatomic vascular malformation. Patients with Abernethy malformation may present with abdominal pain, abnormal liver function tests, hepatopulmonary syndrome, pulmonary hypertension, and/or portosystemic encephalopathy. Accurate identification of the shunt and portal vein and effective management of complications is vital in these patients. Routine imaging examinations are useful for the diagnosis and classification of Abernethy malformation. However, these examinations may miss some portal vein branches. Digital subtraction angiography is invaluable when routine imaging cannot precisely identify the hepatic portal vein in this situation.