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Lupus
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Unique hepatic imaging features in a patient with nodular regenerative hyperplasia of the liver associating with systemic lupus erythematosus

V KS Leung

Department of Medicine & Geriatrics, United Christian Hospital, Hong Kong, SAR, China; vinju{at}netvigator.com

W-L Ng

Department of Medicine & Geriatrics, United Christian Hospital, Hong Kong, SAR

I SC Luk

Department of Pathology, United Christian Hospital, Hong Kong, SAR

T-N Chau

W-H Chan

Department of Medicine & Geriatrics, United Christian Hospital, Hong Kong, SAR

S-K Kei

T KL Loke

Department of Radiology, United Christian Hospital, Hong Kong, SAR

Nodular regenerative hyperplasia (NRH) of the liver, characterized by regenerative nodules distributed throughout the liver in the absence of fibrosis, is a rare but important complication of systemic lupus erythematosus (SLE). The main consequence of NRH is non-cirrhotic portal hypertension. We describe a female patient who had immune thrombocytopenia in association with elevated liver enzymes and evidence of portal hypertension as initial manifestations of SLE. Computed tomographic scan and magnetic resonance imaging of the liver in this patient showed enhancing periportal tubular structures distributed throughout the liver. The diagnosis of NRH was eventually disclosed by transcutaneous needle liver biopsy. The pattern of radiological abnormality in this patient has not been described previously in NRH. In addition, we believe this is a first reported case of SLE presenting with immune thrombocytopenia in association with NRH.

Key Words: computed tomographic scan • magnetic resonance imaging • nodular regenerative hyperplasia • portal hypertension • systemic lupus erythematosus

Lupus, Vol. 16, No. 3, 205-208 (2007)
DOI: 10.1177/09612033707076513
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