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We read with interest the case report by Buchel et al (Gut 2005;54:1021–3). The authors reported on a patient with portal hypertension, nodular regenerative hyperplasia, and portal thrombosis that presented an avascular hip necrosis after liver transplantation (OLT). The authors suggested that the whole clinical picture might stem from hyperhomocysteinaemia (high Hcy) and 677C→T heterozygosity for the common gene of methylene tetrahydrofolate reductase (MTHFR).
Although the history is suggestive of this hypothesis, high Hcy might also be a secondary phenomenon. It …
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