Microangiopathic Hemolytic Anemia Following Transjugular Intrahepatic Portosystemic Shunt Creation in an Adolescent
ABSTRACTTransjugular intrahepatic portosystemic shunt (TIPS) creation is an effective approach to address the complications of portal hypertension. This case report describes an adolescent boy who underwent TIPS creation with an expanded polytetrafluorethylene-lined stent graft for portal hypertensi...
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| Published in | ACG case reports journal Vol. 12; no. 5; p. e01685 |
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| Main Authors | , , |
| Format | Journal Article |
| Language | English |
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Maryland, MD
Wolters Kluwer
01.05.2025
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| Abstract | ABSTRACTTransjugular intrahepatic portosystemic shunt (TIPS) creation is an effective approach to address the complications of portal hypertension. This case report describes an adolescent boy who underwent TIPS creation with an expanded polytetrafluorethylene-lined stent graft for portal hypertension secondary to sinusoidal obstruction syndrome. He subsequently developed microangiopathic hemolytic anemia, an uncommon complication of covered stents that is not well reported in the pediatric population. Despite its rarity and typical conservative management, microangiopathic hemolytic anemia should be considered and regularly monitored in the months following TIPS creation in pediatric patients. |
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| AbstractList | Transjugular intrahepatic portosystemic shunt (TIPS) creation is an effective approach to address the complications of portal hypertension. This case report describes an adolescent boy who underwent TIPS creation with an expanded polytetrafluorethylene-lined stent graft for portal hypertension secondary to sinusoidal obstruction syndrome. He subsequently developed microangiopathic hemolytic anemia, an uncommon complication of covered stents that is not well reported in the pediatric population. Despite its rarity and typical conservative management, microangiopathic hemolytic anemia should be considered and regularly monitored in the months following TIPS creation in pediatric patients. Transjugular intrahepatic portosystemic shunt (TIPS) creation is an effective approach to address the complications of portal hypertension. This case report describes an adolescent boy who underwent TIPS creation with an expanded polytetrafluorethylene-lined stent graft for portal hypertension secondary to sinusoidal obstruction syndrome. He subsequently developed microangiopathic hemolytic anemia, an uncommon complication of covered stents that is not well reported in the pediatric population. Despite its rarity and typical conservative management, microangiopathic hemolytic anemia should be considered and regularly monitored in the months following TIPS creation in pediatric patients.Transjugular intrahepatic portosystemic shunt (TIPS) creation is an effective approach to address the complications of portal hypertension. This case report describes an adolescent boy who underwent TIPS creation with an expanded polytetrafluorethylene-lined stent graft for portal hypertension secondary to sinusoidal obstruction syndrome. He subsequently developed microangiopathic hemolytic anemia, an uncommon complication of covered stents that is not well reported in the pediatric population. Despite its rarity and typical conservative management, microangiopathic hemolytic anemia should be considered and regularly monitored in the months following TIPS creation in pediatric patients. ABSTRACTTransjugular intrahepatic portosystemic shunt (TIPS) creation is an effective approach to address the complications of portal hypertension. This case report describes an adolescent boy who underwent TIPS creation with an expanded polytetrafluorethylene-lined stent graft for portal hypertension secondary to sinusoidal obstruction syndrome. He subsequently developed microangiopathic hemolytic anemia, an uncommon complication of covered stents that is not well reported in the pediatric population. Despite its rarity and typical conservative management, microangiopathic hemolytic anemia should be considered and regularly monitored in the months following TIPS creation in pediatric patients. |
| Author | Lessne, Mark L. Gopalareddy, Vani V. Khoo, Jing Y. |
| Author_xml | – sequence: 1 givenname: Jing Y. surname: Khoo fullname: Khoo, Jing Y. organization: Department of Pediatrics, Atrium Health, Levine Children's Hospital, Charlotte, NC – sequence: 2 givenname: Mark L. surname: Lessne fullname: Lessne, Mark L. email: mark.lessne@charlotteradiology.com organization: Charlotte Radiology, Charlotte, NC – sequence: 3 givenname: Vani V. surname: Gopalareddy fullname: Gopalareddy, Vani V. email: vani.gopalareddy@atriumhealth.org organization: Department of Pediatric Gastroenterology, Hepatology, and Nutrition, Atrium Health, Levine Children's Hospital, Charlotte, NC |
| BackLink | https://www.ncbi.nlm.nih.gov/pubmed/40343219$$D View this record in MEDLINE/PubMed |
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| Cites_doi | 10.1186/s13256-023-03953-7 10.1016/j.jhep.2013.06.014 10.1007/s00383-022-05066-6 10.1155/1996/19343 10.1007/s00270-023-03520-z 10.1016/j.jvir.2023.05.014 10.1007/s00270-007-9262-8 10.1002/hep.510230105 10.1016/j.clinre.2019.09.006 10.1055/s-0039-1688418 |
| ContentType | Journal Article |
| Copyright | 2025 The Author(s). Published by Wolters Kluwer Health, Inc. on behalf of The American College of Gastroenterology. 2025 The Author(s). Published by Wolters Kluwer Health, Inc. on behalf of The American College of Gastroenterology. 2025 |
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| Keywords | microangiopathic hemolytic anemia TIPS-induced hemolytic anemia transjugular intrahepatic portosystemic shunt MAHA pediatric portal hypertension |
| Language | English |
| License | http://creativecommons.org/licenses/by-nc-nd/4.0 2025 The Author(s). Published by Wolters Kluwer Health, Inc. on behalf of The American College of Gastroenterology. This is an open access article distributed under the terms of the Creative Commons Attribution-Non Commercial-No Derivatives License 4.0 (CCBY-NC-ND), where it is permissible to download and share the work provided it is properly cited. The work cannot be changed in any way or used commercially without permission from the journal. |
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| References | Kuei, Mikolajczyk, Niemeyer (R7) 2019; 36 Wang, Ma, Li, Li, Liu (R5) 2022; 38 Rössle (R1) 2013; 59 Mermuys, Maleux, Heye, Lombaerts, Nevens (R3) 2008; 31 Deniz, Schinner, Monroe (R4) 2023; 46 Hermie, Van Cauwenberghe, Dhondt, De Bruyne, Defreyne (R2) 2023; 34 Barnhill, Lizaola-Mayo, Naidu, Shah, Chascsa (R8) 2023; 17 Garcia-Rebollo, González-Reimers, Santolaria-Fernández, Diaz-Romero, Rodriguez-Moreno, Martinez-Riera (R10) 1996; 9 Sanyal, Freedman, Purdum, Shiffman, Luketic (R6) 1996; 23 Dumortier, Menassel, Benech, Bertrand, Valette (R9) 2020; 44 Kuei (R7-20250507) 2019; 36 Dumortier (R9-20250507) 2020; 44 Sanyal (R6-20250507) 1996; 23 Deniz (R4-20250507) 2023; 46 Wang (R5-20250507) 2022; 38 Hermie (R2-20250507) 2023; 34 Garcia-Rebollo (R10-20250507) 1996; 9 Rössle (R1-20250507) 2013; 59 Mermuys (R3-20250507) 2008; 31 Barnhill (R8-20250507) 2023; 17 |
| References_xml | – volume: 9 start-page: 249 issue: 4 year: 1996 end-page: 51 ident: R10 article-title: Transient hemolytic anemia after transjugular intrahepatic portosystemic stent shunt publication-title: HPB Surg. – volume: 38 start-page: 377 issue: 3 year: 2022 end-page: 87 ident: R5 article-title: Feasibility and clinical effectiveness of transjugular intrahepatic portosystemic shunt creation in pediatric and adolescent patients: A meta-analysis publication-title: Pediatr Surg Int. – volume: 34 start-page: 1382 issue: 8 year: 2023 end-page: 98.e10 ident: R2 article-title: Transjugular intrahepatic portosystemic shunts in pediatric portal hypertension: A systematic review and meta-analysis publication-title: J Vasc Interv Radiol. – volume: 23 start-page: 32 issue: 1 year: 1996 end-page: 9 ident: R6 article-title: The hematologic consequences of transjugular intrahepatic portosystemic shunts publication-title: Hepatology (Baltimore, Md). – volume: 36 start-page: 72 issue: 2 year: 2019 end-page: 5 ident: R7 article-title: Hemolytic anemia following stent-graft transjugular intrahepatic portosystemic shunt creation publication-title: Semin Interv Radiol. – volume: 17 start-page: 245 issue: 1 year: 2023 ident: R8 article-title: Transjugular intrahepatic portosystemic shunt-induced hemolysis in a non-cirrhotic patient: A case report publication-title: J Med Case Rep. – volume: 44 start-page: e87 issue: 4 year: 2020 end-page: 8 ident: R9 article-title: Mechanical hemolysis after transjugular intrahepatic portosystemic shunt can occur with covered stent publication-title: Clin Res Hepatol Gastroenterol. – volume: 31 start-page: S192 year: 2008 end-page: 6 ident: R3 article-title: Use of the Viatorr expanded polytetrafluoroethylene-covered stent-graft for transjugular intrahepatic portosystemic shunt creation in children: Initial clinical experience publication-title: Cardiovasc Intervent Radiol. – volume: 59 start-page: 1081 issue: 5 year: 2013 end-page: 93 ident: R1 article-title: TIPS: 25 years later publication-title: J Hepatol. – volume: 46 start-page: 1203 issue: 9 year: 2023 end-page: 13 ident: R4 article-title: Outcome of children with transjugular intrahepatic portosystemic shunt: A meta-analysis of individual patient data publication-title: Cardiovasc Intervent Radiol. – volume: 17 start-page: 245 issue: 1 year: 2023 ident: R8-20250507 article-title: Transjugular intrahepatic portosystemic shunt-induced hemolysis in a non-cirrhotic patient: A case report publication-title: J Med Case Rep. doi: 10.1186/s13256-023-03953-7 – volume: 59 start-page: 1081 issue: 5 year: 2013 ident: R1-20250507 article-title: TIPS: 25 years later publication-title: J Hepatol. doi: 10.1016/j.jhep.2013.06.014 – volume: 38 start-page: 377 issue: 3 year: 2022 ident: R5-20250507 article-title: Feasibility and clinical effectiveness of transjugular intrahepatic portosystemic shunt creation in pediatric and adolescent patients: A meta-analysis publication-title: Pediatr Surg Int. doi: 10.1007/s00383-022-05066-6 – volume: 9 start-page: 249 issue: 4 year: 1996 ident: R10-20250507 article-title: Transient hemolytic anemia after transjugular intrahepatic portosystemic stent shunt publication-title: HPB Surg. doi: 10.1155/1996/19343 – volume: 46 start-page: 1203 issue: 9 year: 2023 ident: R4-20250507 article-title: Outcome of children with transjugular intrahepatic portosystemic shunt: A meta-analysis of individual patient data publication-title: Cardiovasc Intervent Radiol. doi: 10.1007/s00270-023-03520-z – volume: 34 start-page: 1382 issue: 8 year: 2023 ident: R2-20250507 article-title: Transjugular intrahepatic portosystemic shunts in pediatric portal hypertension: A systematic review and meta-analysis publication-title: J Vasc Interv Radiol. doi: 10.1016/j.jvir.2023.05.014 – volume: 31 start-page: S192 issue: Suppl 2 year: 2008 ident: R3-20250507 article-title: Use of the Viatorr expanded polytetrafluoroethylene-covered stent-graft for transjugular intrahepatic portosystemic shunt creation in children: Initial clinical experience publication-title: Cardiovasc Intervent Radiol. doi: 10.1007/s00270-007-9262-8 – volume: 23 start-page: 32 issue: 1 year: 1996 ident: R6-20250507 article-title: The hematologic consequences of transjugular intrahepatic portosystemic shunts publication-title: Hepatology (Baltimore, Md). doi: 10.1002/hep.510230105 – volume: 44 start-page: e87 issue: 4 year: 2020 ident: R9-20250507 article-title: Mechanical hemolysis after transjugular intrahepatic portosystemic shunt can occur with covered stent publication-title: Clin Res Hepatol Gastroenterol. doi: 10.1016/j.clinre.2019.09.006 – volume: 36 start-page: 72 issue: 2 year: 2019 ident: R7-20250507 article-title: Hemolytic anemia following stent-graft transjugular intrahepatic portosystemic shunt creation publication-title: Semin Interv Radiol. doi: 10.1055/s-0039-1688418 |
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| Snippet | ABSTRACTTransjugular intrahepatic portosystemic shunt (TIPS) creation is an effective approach to address the complications of portal hypertension. This case... Transjugular intrahepatic portosystemic shunt (TIPS) creation is an effective approach to address the complications of portal hypertension. This case report... |
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| Title | Microangiopathic Hemolytic Anemia Following Transjugular Intrahepatic Portosystemic Shunt Creation in an Adolescent |
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