An observational study in Portal Hypertension, Budd-Chiari Syndrome and Non-Cirrhotic Portal Hypertension, sponsored by Post Graduate Institute of Medical Education and Research, Chandigarh. Status unknown at 1 site in India. Open to participants aged 12 Years to 70 Years. Per ClinicalTrials.gov, last updated 2024-04-25.
Sponsored by Post Graduate Institute of Medical Education and Research, Chandigarh · Observational
There is a need to re-evaluate the patients classified as NCPH and determine whether the new histological classification proposed by the VALDIG applies to the Indian scenario. We intend to identify the patient cohorts who have been diagnosed as NCPH, NCPF, EHPVO, hepatic venous outlet tract obstruction (HVOTO), Veno-occlusive disease (VOD) and sinusoidal obstruction syndrome (SOS) based on their liver biopsy, endoscopy, HVPG, and radiology reports. These patients will be screened to find the patients who fit the diagnosis of PSVD. It is important to establish whether the new definition of PSVD is relevant to the Indian population and establish the usefulness of invasive tests like liver biopsy in diagnosing the disease. The patient cohorts meeting diagnosis of INCPH will be compared with those meeting the new diagnosis of PSVD. The investigators will describe the clinical (demographic, clinical risk factors, socioeconomic status), etiological (associated conditions, coagulation disorders medication use, genetic risk factors), imaging (based on ultrasound Doppler imaging or cross- sectional imaging), endoscopic, fibrosis tests (using non-invasive tests), and the histopathology of the patients who fulfil the criteria of PSVD.
Portal hypertension is clinically characterized by a portal venous pressure gradient between the inferior vena cava and the portal vein is more than 5 mm. Liver cirrhosis remains the leading cause of portal hypertension in the western world. However, there are conditions where portal hypertension can even occur without liver cirrhosis, referred to as Noncirrhotic portal hypertension (NCPH). The term NCPH has been derived from a variety of histopathological entities such as hepatoportal sclerosis, noncirrhotic portal fibrosis, nodular regenerative hyperplasia, or incomplete septal fibrosis. In the absence of other causes of cirrhosis and portal venous thrombosis, the condition is termed idiopathic noncirrhotic portal hypertension. The histopathological findings of INCPH are not entirely specific to portal hypertension, similar changes can be seen in patients without portal hypertension. Therefore the term Porto-sinusoidal vascular disorder(PSVD) has been recently introduced to define a group of liver vessel disorders affecting the portal venules and sinusoids irrespective of the absence or presence of liver cirrhosis. This disease entity can have a varied clinical presentation and histological findings and has been associated with several immunological and systemic disorders.
Porto-sinusoidal vascular disease - Currently, for clinical practice, the VALDIG group has given a working definition for PSVD.
"Liver biopsy ≥20mm without cirrhosis with either 1 specific sign of portal hypertension OR 1 specific histological finding for PSVD" OR "Liver biopsy ≥20mm without cirrhosis with 1 sign not specific for portal hypertension AND 1 sign not specific for PSVD"
345 studies on the registry are indexed under Hypertension, Portal; 110 are open to participants now.
This study's planned enrollment of 210 is above the median of 151 across 128 observational studies indexed under Hypertension, Portal.
Browse Hypertension, Portal studies →Post Graduate Institute of Medical Education and Research, Chandigarh is the lead sponsor of 296 studies on the registry; 44 are open to participants now.
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Patients diagnosed as NCPF, EHPVO, HVOTO, SOS, VOD will be screened for reclassification based on diagnostic criteria for PSVD
Go through the criteria one by one — yes, no or not sure — and take the list to your doctor or the study team. Kept in this browser only.
Exclusion Criteria:
To describe the clinical presentation of patients with a diagnosis of PSVD.
Listing clinical presentation (signs and symptoms) of patients with PSVD (variceal bleeding, pain, ascites, sensation of lump, etc)
Time frame: Day 0
Radiological description of patients with PSVD based on CT venography
Radiological assessment will be done at baseline for characterization of changes of portal vein, small hepatic veins, liver and splenic morphology. Doppler of the portal vessels.
Time frame: Day 0
Radiological description of patients with PSVD based on Doppler Ultrasound
Radiological assessment will be done at baseline for characterization of changes of portal vein, small hepatic veins, liver and splenic morphology. Doppler of the portal vessels.
Time frame: Day 0
Histopathological features and subtypes of the PSVD spectrum in patients from India with assessment of parenchyma, vessels, portal triad and fibrosis
To classify the PSVD based on the histological finding the disease.
Time frame: Day 0
Ratio of liver stiffness and splenic stiffness using transient elastography in diagnosis of PSVD
To look for the trend of non-invasive techniques in PSVD such as ARFI, transient elastography, coagulation parameters, and inflammatory biomarkers in patients of PSVD
Time frame: Day 0
Change in biomarkers like Factor VIII Ag or vWF in diagnosis of PSVD
To look for the trend of non-invasive techniques in PSVD such as coagulation parameters, and inflammatory biomarkers in patients of PSVD
Time frame: Day 0
Presence of varices and other endoscopic findings in patients with PSVD
To look for esophageal varices and portal hypertensive gastropathy
Time frame: Day 0
Plan to share: No
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This study is status unknown, as verified in Apr 2024. You cannot join it, but the record below documents what was studied.
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Post Graduate Institute of Medical Education and Research, Chandigarh →