Nodular regenerative hyperplasia

Hi,

Nodular regenerative hyperplasia does anybody have this rare condition? If so, could you tell me about it please?

[Fibro2021]

Hi,

A rare diagnosis and a rare disease are not the same thing. As far as I know, NRH (nodular regenerative hyperplasia) is very difficult to diagnose and can only be detected through a properly performed liver biopsy with additional staining of histological samples using reticulin stain.

The main challenge in diagnosing NRH lies in the fact that physicians rarely consider it as a working hypothesis. Its symptoms can mimic those of liver cirrhosis, but imaging methods such as ultrasound, MRI, CT, or Fibroscan, along with biochemical blood tests, often fail to reveal any abnormalities. Liver panel indicators usually remain within the normal range.

As the pathological process progresses, regenerative nodules in the liver grow, compressing the liver tissue inside and leading to the development of non-cirrhotic portal hypertension (NCPH). NCPH can cause symptoms of hepatic encephalopathy (HE) ranging from minimal manifestations like chronic fatigue and sleep disturbances to hepatic coma.

Additionally, NRH may lead to variceal bleeding in the esophagus. The absence of liver cirrhosis in such cases raises suspicion of NCPH and consequently NRH.

Persons with NRH are often mistakenly referred to psychiatrists misinterpreting symptoms of minimal hepatic encephalopathy as symptoms of other mental illnesses, even though psychiatric medications can exacerbate liver issues if NRH is not promptly diagnosed. Delayed diagnosis of NRH and misdiagnosis of other conditions result in significant financial burdens for healthcare systems, which could otherwise allocate these resources to other important areas.

I’m curious, have you already been diagnosed with NRH? Did you undergo a liver biopsy? I understand the difficulties patients face when being diagnosed with NRH (based on my own experience), so I’d be interested to know how the process unfolded in your case. If the diagnosis has been confirmed, do you know the potential cause of NRH in your situation?