Portal hypertension arsenic

Huet, P.M., Guillaume, E. and Cote, J. (1975) Noncirrhotic presinusoidal portal hypertension associated with chronic arsenical intoxication. Gastroenterology, 68(5), 1270-77. 

Arsenic Arsenic poisoning is of great medicohistorical interest, (s. p. 564) Chronic arsenic intoxication can be caused by inhalation or, more often, by oral uptake. Steatosis and cell necrosis occur in the liver fibrosis or cirrhosis with portal hypertension and oesophageal varices develop. The presence of liver adenoma and VOD as well as hver carcinoma or haemangioendothelioma has been described. (16, 42, 50, 53, 60, 76)... 

Duenas C, Perez-Alvarez JC, Busteros Jl, Saez-Royuela F, Martin-Lorente JL, Yuguero L, Lopez-Morante A. Idiopathic portal hypertension and angiosarcoma associated with arsenical salts therapy. J Clin Gastroenterol 1998 26(4) 303-5. 

Viudez P, Castano G, Sookoian S, Frider B, Alvarez E. Arsenic and portal hypertension. Am J Gastroenterol 2000 95(6) 1602-4. 

B. Chronic intoxication is also associated with multisystemic effects, which may include fatigue and malaise, gastroenteritis, leukopenia and anemia (occasionally megaloblastic), sensory predominant peripheral neuropathy, hepatic transaminase elevation, nonciiihotic portal hypertension, and peripheral vascular insufficiency. Skin disorders and cancer may occur (see below), and a growing body of epidemiological evidence links chronic arsenic ingestion with an increased risk of hypertension, cardiovascular mortality, and diabetes mellitus. 

Fibrosis usually results from chronic inflammation, which can be the result of continuous exposure to a variety of hepatotoxic chemicals, such as organic arsenicals, vinyl chloride, or high doses of vitamin A (Zimmerman, 1999), chronic ethanol ingestion, and NAFLD. Fibrosis usually occurs around the portal area, in the space of Disse, and around the central veins. This results in loss of liver architecture and function. The hepatocytes are replaced with fibrous material, and thus there is hepatocyte loss. Periportal fibrosis may lead to portal hypertension. 

Again several reports stress the tri c consequences of the use of arsenic for medical purposes (Le. Fowler s solution). Angiosarcoma of the liver (7 ), multiple basal cell carcinoma (S -, 9 -), polyneuropathy (10 ). and non-cirrhotic portal hypertension (11 , 12) have been reported. Further study is required to assess the evidence that arsenic can also induce internal malignant tumours (8,9). 

Datta, D. V. (1976) Arsenic and non-cirrhotic portal hypertension. Lancet, Febr.,A iZ. 

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