Noncirrhotic Portal Hypertension in Systemic Lupus Erythematosus Complicated by Hepatic Microabscesses After Transjugular Intrahepatic Portosystemic Shunt

Noncirrhotic portal hypertension (NCPH) as a complication of systemic lupus erythematosus (SLE) is rare. We present the case of a young woman with SLE and refractory ascites, with biopsy-confirmed NCPH. The clinical course was complicated by the development of hepatic microabscesses and severe hepatic ischemic injury following transjugular intrahepatic portosystemic shunt (TIPS) placement. Bacterial seeding of the TIPS stent, followed by showering of the liver parenchyma, is the proposed culprit mechanism. This case highlights a novel infectious complication of TIPS in the setting of SLE-associated NCPH, thereby enhancing our understanding of hepatic manifestations in patients with lupus.