Veno-occlusive disease hepatic

Busulfan -alkylating agent -bone marrow suppression—can have prolonged nadir -ovarian suppression -seizures -hepatic veno-occlusive disease (VOD), particularly at BMT doses -interstitial pulmonary fibrosis -hyperpigmentation (particularly skin creases and nail beds)... 

Hepatic Effects. Severe cirrhosis of the liver was one of the primary systemic effects seen following injection of Thorotrast in humans (Baxter et al. 1980a, b Faber 1979 Kato and Kido 1987 Kato et al. 1983 Mori et al. 1979, 1983a, b Rao et al. 1986 Van Kaick et al. 1983). Cases of fibrosis, veno-occlusive disease, and blood-filled cavities were also found in the livers of Thorotrast patients (da Silva Horta 1967a Dejgaard et al. 1984). The latency period for the appearance of the cirrhosis was not clear, but was probably comparable to the latency period for liver tumors (25-30 years) since the two effects were often found together. 

Cl) = 0.30 - 0.92] was offset by an increased risk of death in remission (OR = 2.22, 95% Cl = 1.20 - 4.14), mainly due to infections. Strikingly, 11% of patients in the 6-TG arm compared to less than 2% in the 6-MP arm developed non-fatal hepatic toxicity with features of veno-occlusive disease (VOD) characterized by symptoms including tender hepatomegaly, hyperbilirubinaemia with elevated aminotransferases, thrombocytopenia out of proportion to neutropenia, and portal hypertension. In 85% of affected 6-TG recipients, these symptoms were observed during maintenance or interim maintenance. Of interest, in patients randomized to 6-MP, hepatic toxicity was associated with intensification elements in which both treatment arms received exclusively 6-TG. 

Occasionally toxic compounds can directly damage the hepatic sinusoids and capillaries. One such toxic compound is monocrotaline, a naturally occurring pyrrolozidine alkaloid, found in certain plants (Heliotropium, Senecio, and Crotolaria species). Monocrotaline (Fig. 7.7) is metabolized to a reactive metabolite, which is directly cytotoxic to the sinusoidal and endothelial cells, causing damage and occlusion of the lumen. The blood flow in the liver is therefore reduced and ischemic damage to the hepatocytes ensues. Centrilobular necrosis results, and the venous return to the liver is blocked. Hence, this is known as veno-occlusive disease and results in extensive alteration in hepatic vasculature and function. Chronic exposure causes cirrhosis. 

The incidence of hepatic veno-occlusive disease in 249 consecutive women treated with norethisterone who... 

SPERL, W., STUPPNER, H., GASSNER, I., JUDMAIER, W., DEETZE, O., VOGEL, W., Reversible hepatic veno-occlusive disease in an infant after consumption of pyrrolizidine-containing herbal tea., Eta. J. Pediatr., 1995, 154, 112-116. 

ZUCKERMAN, M STEENKAMP, V., STEWART, M.J., Hepatic veno-occlusive disease as a result of a traditional remedy confirmation of toxic pyrrolizidine alkaloids as the cause, using an in vitro technique., J. Clin. Pathol., 2002, 55, 676-679. 

Gastrointestinal GI hypersensitivity reaction, nausea, vomiting, pancreatitis, hepatotoxicity, hepatic veno-occlusive disease... 

Herbal medicines are becoming more and more popular, and indeed some herbal products may be considered to benefit people with liver disease, e.g. Silybum marianum (milk thistle), Picrorhiza kurroa, Phyllanthus, etc. Herbal hepatotoxicity is increasingly being recognised, for example, with kava kava, black cohosh, and many traditional Chinese remedies. The range of liver injury includes minor transaminase elevations, acute and chronic hepatitis, steatosis, cholestasis, zonal or diffuse hepatic necrosis, veno-occlusive disease and acute liver failure. In addition to the potential for hepatotoxicity, herb-drug interactions may affect the safety and efficacy of concurrent medical therapy [15]. 

Busulfan Nausea and vomiting rarely diarrhoea Bone marrow depression pulmonary infiltrates and fibrosis alopecia gynaccomasiia ovarian failure hyperpigmentation azoospermia leukaemia chromosome aberrations cataracts hepatitis seizures and veno-occlusive disease with high doses... 

Magnetic resonance imaging in the staging of hepatic veno-occlusive disease. Eur. J. Gastroenterol. Hepatol. 1994 6 453-456... 

An increase in blood both in the sinusoids and in Disse s spaces culminates in hepatomegaly. This can be witnessed particularly in cases of right heart failure, constrictive pericarditis, veno-occlusive disease and the Budd-Chiari syndrome. Inflammation-related hyper-aemia also occurs in acute viral hepatitis. 

Veno-occlusive disease (VOD) describes the occlusion of small hepatic veins and is defined as a radicular form of the Budd-Chiari syndrome. A variety of endotheliotoxic noxae, particularly phytotoxins, are responsible for this clinical picture. In 1951 reports were simultaneously published for the first time both in South Africa (G. Selzer et al.) and Jamaica (K. R. Hill) dealing with this disease of the small venous branches, which results from chronic intoxication with pyrrolizidine alkaloids, (s. pp 548, 571) Similar morphological and clinical effects can also be caused by cytostatic agents (6-mercaptopurine, dacarbazine, thioguanine), azathioprine, contraceptives and exposure to X-rays. Since 1957, the term Stuart-Bras syndrome has also been used to describe the occlusion of the small hepatic veins, (s. p. 832)... 

Budd-Chiari syndrome, heatstroke, ligature of the hepatic artery, shock liver, veno-occlusive disease... 

The hepatic veins may be affected by xenobiotic-induced occlusion resulting from thrombosis or from proliferation starting in the intima and subsequently producing (secondary) thrombosis. An occlusion of the large hepatic veins is known as the Budd-Chiari syndrome. There are two distinct types, the truncular and the radicular form, the latter corresponding to veno-occlusive disease, (s. p. 249) Contraceptives (J.A. Ecker et al., 1966) and cytostatic agents are held responsible. Women develop this type of hepatic disease more than twice as often as men. (s. fig. 29.9)... 

Pappas, S.C., Malone, D.G., Rabin, L., Hoofnagle, J.H., Jones, EA. Hepatic veno-occlusive disease in a patient with systemic lupus erythematosus. Arthr. Rheum. 1984 27 104-108... 

Veno-occlusive disease (VOD) is characterized by thrombosis of the central and small (sublobular) hepatic veins. It is also known as the radicular form of the Budd-Chiari syndrome or as the Stuart-Bras syndrome, (s. tab. 14.5) (75, 92, 93)... 

Kumar, S., Deleve, L.D., Kamath, P.S., Tefferi, A. Hepatic veno-occlusive disease (sinusoidal obstruction syndrome) after hematopoetic stem cell transplantation (review). Mayo CHn. Proc. 2003 78 589-598... 

Lassau, N., Leclere, J., Auperin, A., Bourhis, J.H., Hartmann, O., Val-teau-Couanet, D., Benhamou, E., Bosq, J., Ibrahim, A., Girinski, T., Pico, J.L., Roche, A. Hepatic veno-occlusive disease after myeloablativ treatment and bone marrow transplantation value of Gray-scale and Doppler US in 100 patients. Radiology 1997 204 545-552... 

A 19-year-old woman developed severe acute hepatitis and peripheral eosinophilia during oral trovafloxacin therapy for recurrent sinusitis (9). Liver biopsy showed extensive centrilobular hepatocyte necrosis, probably causing veno-occlusive disease. Clinical and laboratory abnormalities resolved completely after prolonged treatment with steroids. 

Hepatic veno-occlusive disease occurred in a 38-year-old woman who had occasionally consumed Huamanrripa (Senecio tephrosioides) as a cough remedy for many years (35). She had abdominal pain, jaundice, and anasarca. A hepatic biopsy showed pronounced congestion with a centrilobular predominance, foci of necrosis, and in some areas a reversed lobulation pattern. During the next 13 months she was hospitalized four times with complications of portal hypertension. 

An infant developed hepatic veno-occlusive disease after having been fed a herbal tea known as gordolobo yerba, commonly used as a folk remedy among Mexican-Americans there was acute hepatocellular disease and portal hypertension, which progressed over 2 months to extensive hepatic fibrosis (36). 

Stilhnan AS, Huxtable R, Consroe P, Kohnen P, Smith S. Hepatic veno-occlusive disease due to pyrrohzidine Senecio) poisoning in Arizona. Gastroenterology 1977 73(2) 349-52. 

Read AE, Wiesner RH, LaBrecque DR, Tifft JG, Mullen KD, Sheer RL, Petrelli M, Ricanati ES, McCullough AJ. Hepatic veno-occlusive disease associated with renal transplantation and azathioprine therapy, Ann Intern Med 1986 104(5) 651-5. 

The main type of Uver damage caused by S. officinale is veno-occlusive disease, a non-thrombotic obliteration of small hepatic veins leading to cirrhosis and eventually liver failure (3). Patients can present with acute or chronic signs portal hypertension, hepatomegaly, and abdominal pain are the main features. 

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