Idiopathic Portal Hypertension in Two Cases of Diverse Backgrounds: Retrospective Review of Liver biopsies
Bibliographic record
Abstract
Idiopathic portal hypertension (IPH) is a clinical syndrome of unknown etiology with increased portal caval pressure secondary to portal vein fibrosis. Clinically patients may present with gastrointestinal bleeding, ascites, and pancytopenia. IPH is considered equivalent to noncirrhotic portal fibrosis (NCPF) of India and hepatoportal sclerosis of United States. Retrospectively we reviewed total 196 cases of liver biopsies over 2 years, which revealed seven vascular lesions, out of seven vascular lesions, two cases showed idiopathic portal and mesenteric vein thrombosis. Both cases were of diverse background. First case of an immigrant young female from India had previous liver disease (nonspecific). About 10 years ago, she had splenectomy done secondary to MVA. Liver biopsy done that time was inclusive. Second case was of an elderly male with chronic alcohol abuse. Liver biopsy in first case showed enlarged portal triads with fibrosis, few missing portal veins and dilated portal vein with thrombosis. There was periportal atrophy of hepatocytes with lobular hepatocytes showing individual cell necrosis. Second case showed features consistent with large vein thrombosis and increased fibrosis without significant changes in liver parenchyma. Both these cases had CT proven portal / mesenteric vein thrombosis. Liver biopsies in both patients were done to rule out other underlying pathologies and to confirm the diagnosis. Both patients had normal liver enzymes. IPH is a rare entity, which was only identified in 2/196 consecutive liver biopsies in 2-year data review. Both clinically and morphologically, IPH is a diagnosis of exclusion, so pathologist's awareness about this entity will ultimately lead to an early diagnosis, which will improve patient care. Keywords: Idiopathic portal hypertension, portal vein thrombosis. Abbreviations used: IPH; Idiopathic portal hypertension, NCPF; Non cirrhotic portal fibrosis, CT; Computed tomography and MVA; Motor vehicle accident.
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How this classification was reachedexpand
Full frame machine prediction
Teacher imitationNot calibrated prevalence, not ground truth. Human validation pending. The Gemma side is a direct model label for every work in the frame, read from the title-only record. The Codex side is a classifier learned from the 10,348 direct Codex labels and calibrated to design-weighted sample rates; fields without enough sample support carry no Codex call. Candidate is the union of the two sides; consensus is their intersection. These outputs are machine_predicted_unvalidated and are not human labels.
Distilled classifier scores by category (both heads)
| Category | Codex | Gemma |
|---|---|---|
| Metaresearch | 0.001 | 0.005 |
| Meta-epidemiology (narrow) | 0.001 | 0.001 |
| Meta-epidemiology (broad) | 0.001 | 0.001 |
| Bibliometrics | 0.004 | 0.002 |
| Science and technology studies | 0.001 | 0.001 |
| Scholarly communication | 0.001 | 0.001 |
| Open science | 0.001 | 0.001 |
| Research integrity | 0.001 | 0.001 |
| Insufficient payload (model declined to judge) | 0.001 | 0.001 |
Machine scores (provisional)
The two teacher heads of the student model, read on this work. A score orders the frame for review; it never asserts a category, and the validation status ships verbatim with every row.
Baseline scores from an immature model (maturity gate not passed, 7 training rounds). Scores rank; they never assert a category.
score_only:v0-immature-baseline · verbatim from the scoring run: score_only means the number may rank works, and no category label ships from itClassification
machine, unvalidatedMachine predicted; a candidate call from one source (direct Gemma or distilled Codex), not a consensus.
How this classification was reached, model by model and score by score, is at the end of the page under "How this classification was reached".