Banti's Syndrome

Banti's Syndrome

National Organization for Rare Disorders, Inc.

Important

It is possible that the main title of the report Banti's Syndrome is not the name you expected. Please check the synonyms listing to find the alternate name(s) and disorder subdivision(s) covered by this report.

Synonyms

  • Banti's Disease
  • Hypersplenism
  • Idiopathic portal hypertension
  • Idiopathic congestive splenomegaly

Disorder Subdivisions

  • None

General Discussion

Banti syndrome is a disorder of the spleen, the large, gland-like organ in the upper left side of the abdomen that produces red blood cells before birth and, in newborns, removes and destroys aged red blood cells, and plays a role in fighting infection. In the case of Banti syndrome, the spleen rapidly but prematurely destroys blood cells.



This syndrome is characterized by abnormal enlargement of the spleen (splenomegaly) due to obstruction of blood flow in some veins and abnormally increased blood pressure (hypertension) within the veins of the liver (e.g., hepatic or portal veins), or the spleen (splenic veins). The disorder may be due to any number of different factors causing obstruction of portal, hepatic, or splenic veins including abnormalities present at birth (congenital) of such veins, blood clots, or various underlying disorders causing inflammation and obstruction of veins (vascular obstruction) of the liver.

Symptoms

In early stages, symptoms of Banti syndrome include weakness, fatigue, anemia , and abnormal enlargement of the spleen. As the disorder progresses, the anemia becomes more severe. The anemia may be aggravated by a bleeding esophagus that may cause vomiting of blood and the passage of dark stools composed of decomposing blood. Ultimately, in some cases, the liver itself becomes enlarged and subdivided by fibrous tissue (cirrhosis). However, the spleen enlargement in Banti syndrome is the primary symptom.



Patients with Banti syndrome bruise easily, are more likely to contract bacterial infections and carry a fever for longer periods of time.



Symptoms may also include abnormal accumulation of fluid in the abdominal cavity (ascites), weakness, fatigue; abnormally low levels of circulating red blood cells (anemia), white blood cells (leukopenia), and/or platelets (thrombocytopenia), and/or episodes of bleeding (hemorrhage) from the gastrointestinal tract.

Causes

Banti syndrome may occur due to a number of different factors causing obstruction of, and abnormally increased blood pressure (hypertension) within, certain veins of the spleen (splenic veins) or the liver (e.g., hepatic or portal veins). These may include abnormalities present at birth (congenital) of such veins, blood clots, or various underlying disorders causing inflammation and obstruction of veins (vascular obstruction) of the liver, such as cirrhosis. Increased arsenic intake has also been implicated in some cases. Also, cases have occurred in patients taking long-term azathioprine, particularly after kidney transplantation.

Affected Populations

Banti syndrome affects males and females equally. It is relatively common in parts of India and Japan, but rare in Western countries. Increased arsenic levels are present in drinking water in some countries and may contribute to regional differences in incidence.

Standard Therapies

Diagnosis

The diagnosis of Banti syndrome my be confirmed by a thorough clinical evaluation and a variety of specialized tests, particularly advanced imaging techniques such as a splenic venography and magnetic resonance imaging (MRI). During MRI, a magnetic field and radio waves are used to create cross-sectional images of targeted parts of the body.



Treatment

Treatment of Banti syndrome is dependent upon the cause. If a contributing factor such as arsenic or azathioprine is identified, the exposure should be stopped.



The main clinical problem is bleeding from esophageal or gastric swollen blood vessels (varices). Active bleeding may be treated with vasoconstrictor drugs or other methods used to treat portal hypertension. Recurrent bleeding may require that blood flow be rerouted by a surgical shunt. An orphan drug for bleeding esophageal varices, Ethamolin, was approved by the U.S. Food and Drug Administration (FDA) in 1988.

Investigational Therapies

Information on current clinical trials is posted on the Internet at www.clinicaltrials.gov. All studies receiving U.S. government funding, and some supported by private industry, are posted on this government web site.



For information about clinical trials being conducted at the NIH Clinical Center in Bethesda, MD, contact the NIH Patient Recruitment Office:



Tollfree: (800) 411-1222

TTY: (866) 411-1010

Email: prpl@cc.nih.gov



For information about clinical trials sponsored by private sources, contact:

www.centerwatch.com

References

TEXTBOOKS

McCormick PA. Banti syndrome. In: NORD Guide to Rare Disorders. Lippincott Williams & Wilkins. Philadelphia, PA. 2003:377-78.



Beers MH, Berkow R., eds. The Merck Manual, 17th ed. Whitehouse Station, NJ: Merck Research Laboratories; 1999:973.



Behrman RE, Kliegman RM, Arvin AM. Eds. Nelson Textbook of Pediatrics. 15th ed. W.B. Saunder Company. Philadelphia, PA; 1996:1439.



JOURNAL ARTICLES

Waqar SN, Jindani S, Baig NS, et al. Banti's syndrome: case report and review of the literature. J Pak Med Assoc. 2004;54:99-101.



Pickhardt PJ, Balfe DM. Portal vein calcification and associated biliary stricture in idiopathic portal hypertension (Banti's syndrome). Abdom Imaging. 1998;23:180-82.



FROM THE INTERNET

Banti's disease. Who Named It? nd. 2pp.

www.whonamedit.com/synd.cfm/475.html

Resources

American Liver Foundation

39 Broadway, Suite 2700

New York, NY 10006

USA

Fax: (212)483-8179

Tel: (800)465-4837

Email: http://www.liverfoundation.org/contact/

Internet: http://www.liverfoundation.org



NIH/National Institute of Diabetes, Digestive & Kidney Diseases

Office of Communications & Public Liaison

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Bethesda, MD 20892-2560

Tel: (301)496-3583

Email: NDDIC@info.niddk.nih.gov

Internet: http://www2.niddk.nih.gov/



Genetic and Rare Diseases (GARD) Information Center

PO Box 8126

Gaithersburg, MD 20898-8126

Tel: (301)251-4925

Fax: (301)251-4911

Tel: (888)205-2311

TDD: (888)205-3223

Internet: http://rarediseases.info.nih.gov/GARD/



For a Complete Report

This is an abstract of a report from the National Organization for Rare Disorders, Inc.® (NORD). Cigna members can access the complete report by logging into myCigna.com. For non-Cigna members, a copy of the complete report can be obtained for a small fee by visiting the NORD website. The complete report contains additional information including symptoms, causes, affected population, related disorders, standard and investigational treatments (if available), and references from medical literature. For a full-text version of this topic, see http://www.rarediseases.org/search/rdblist.html.

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