A patient with idiopathic portal hypertension with pancytopenia on long-term hemodialysis treatment

Abstract

We report a 51-year old man with idiopathic portal hypertension (IPH) receiving long-term hemodialysis treatment, who developed pancytopenia that had mildly progressed over a five-year period before the current admission. Abdominal ultrasound showed splenomegaly, and abdominal computed tomography showed dilatation of the portal and paraumbilical veins. Neither hematological nor collagen disease was suggested. We concluded that the patient had idiopathic portal hypertension, and splenectomy was performed. Liver biopsy was simultaneously performed and histological analysis demonstrated normal liver tissue ; there was no evidence of any excess inflammation and no features to suggest cirrhosis or drug-induced liver disease, consistent with IPH. Post operatively, recovery was uneventful and rapid improvement of pancytopenia was observed.