Child ; Female ; Hepatic Veno-Occlusive Disease ; diagnosis ; pathology ; therapy ; Humans ; Liver ; pathology

Adult ; Drugs, Chinese Herbal ; adverse effects ; Female ; Hepatic Veno-Occlusive Disease ; chemically induced ; diagnosis ; pathology ; Humans ; Male ; Middle Aged

OBJECTIVETo summarize the clinical experiences in the diagnosis and managements of hepatic veno-occlusive disease (HVOD).

METHODSThe clinical and pathologic data of 17 patients with hepatic veno-occlusive disease were analyzed retrospectively.

RESULTSAccording to the results of imaging examination, clinical data and pathological data, 17 patients HVOD were divided into acute progressive HVOD and chronic HVOD. 2 cases out of the 11 acute progressive cases got improved, 2 cases died after medical treatment and 2 cases died after shunt operation. The 6 chronic HVOD, including 1 case with medical treatment and 5 cases with shunt operation, were cured.

CONCLUSIONLiver biopsy was an efficient method for the diagnosis of hepatic veno-occlusive disease. Acute progressive cases of hepatic veno-occlusive disease should be managed with medical treatment and the chronic cases could be treated with shunt surgery if medical treatment were inefficient.

Adult ; Aged ; Female ; Hepatic Veins ; pathology ; Hepatic Veno-Occlusive Disease ; diagnosis ; pathology ; therapy ; Humans ; Male ; Middle Aged ; Retrospective Studies ; Young Adult

Hepatic sinusoidal obstruction syndrome (HSOS) via exposure to pyrrolizidine alkaloids (PAs) is with high mortality and there is no effective treatment in clinics. Bear bile powder (BBP) is a famous traditional animal drug for curing a variety of hepatobiliary diseases such as cholestasis, inflammation, and fibrosis. Here, we aim to evaluate the protective effect of BBP against HSOS induced by senecionine, a highly hepatotoxic PA compound. Our results showed that BBP treatment protected mice from senecionine-induced HSOS dose-dependently, which was evident by improved liver histology including reduced infiltration of inflammatory cells and collagen positive cells, alleviated intrahepatic hemorrhage and hepatic sinusoidal endothelial cells, as well as decreased conventional serum liver function indicators. In addition, BBP treatment lowered matrix metalloproteinase 9 and pyrrole-protein adducts, two well-known markers positively associated with the severity of PA-induced HSOS. Further investigation showed that BBP treatment prevents the development of liver fibrosis by decreasing transforming growth factor beta and downstream fibrotic molecules. BBP treatment also alleviated senecionine-induced liver inflammation and lowered the pro-inflammatory cytokines, in which tauroursodeoxycholic acid played an important role. What's more, BBP treatment also decreased the accumulation of hydrophobic bile acids, such as cholic acid, taurocholic acid, glycocholic acid, as well. We concluded that BBP attenuates senecionine-induced HSOS in mice by repairing the bile acids homeostasis, preventing liver fibrosis, and alleviating liver inflammation. Our present study helps to pave the way to therapeutic approaches of the treatment of PA-induced liver injury in clinics.
Animals ; Bile ; Bile Acids and Salts ; Endothelial Cells/metabolism* ; Hepatic Veno-Occlusive Disease/pathology* ; Inflammation/pathology* ; Liver Cirrhosis/drug therapy* ; Mice ; Powders ; Pyrrolizidine Alkaloids/adverse effects* ; Ursidae

OBJECTIVETo discuss the clinical characteristics and precautionary measures of hepatic veno-occlusive disease (VOD) caused by Sedum aizoon.

METHODThe VOD induced by Sedum aizoon were reports in 41 patients comimg from national medical journals from 1998 to 2007 and their use and dose were analyzed.

RESULTThe results shows that ADR of Sedum aizoon was serious. VOD has relationship with it, s dose use time the age of the patients and individual difference.

CONCLUSIONTo avoid of VOD induced by Sedum aizoon, it should be done through strengthening study on pharmacology and toxicology of Sedum aizoon. Enhancing patients of safety awareness, standardizing usage and dosage to guide the clinically rational use of drugs.

Adult ; Aged ; Drugs, Chinese Herbal ; adverse effects ; Female ; Hepatic Veno-Occlusive Disease ; chemically induced ; pathology ; Humans ; Male ; Middle Aged ; Sedum ; chemistry

This study was purposed to investigate the role of monocrotaline-inducing mouse liver sinusoid endothelial cell (SEC) injury in hepatic veno-occlusive disease. BALB/c mice were randomly divided into 2 groups: control group and monocrotaline group, mice were orally administrated with normal saline or monocrotaline with concentration of 200 mg/kg at days 0, 1, 2, respectively. At days 3, 4, 6, 8 and 10 after oral administration with normal saline or monocrotaline, the liver function (ALT, TBIL, AKP) and liver index were examined, and the percentage of activated platelets were detected by flow cytometry. The SEC, vascular endothelial cells and hepatic fibrosis were observed by staining with hematoxylin-eosin and Masson. Transmission electron microscopy was used to observe sinusoidal endothelial cell damage and platelet adhesion. The results showed that compared with control group, mice in monocrotaline group were characterized by severe damage of SEC, numbers of platelet aggregation and adhesion, central number and sinusoidal fibrosis. The percentage of activated platelets and liver index increased (P < 0.05). The characterization of portal hypertension was presented later, such as dysfunction of liver and ascites. It is concluded that SEC injury induced by monocrotaline may be the first step of hepatic veno-occlusive disease, and this kind of SEC injury is self-limiting, but fibrosis is always observed.
Animals ; Endothelial Cells ; pathology ; Endothelium ; cytology ; Hepatic Veins ; cytology ; pathology ; Hepatic Veno-Occlusive Disease ; chemically induced ; pathology ; Liver Cirrhosis ; chemically induced ; pathology ; Male ; Mice ; Mice, Inbred BALB C ; Monocrotaline ; adverse effects ; Platelet Adhesiveness

No abstract available.
Antineoplastic Agents/*adverse effects/therapeutic use ; Colorectal Neoplasms/drug therapy/pathology ; Female ; Hepatic Veno-Occlusive Disease/*pathology ; Humans ; Liver Neoplasms/drug therapy/secondary ; Middle Aged ; Organoplatinum Compounds/*adverse effects/therapeutic use ; Tomography, X-Ray Computed

Adolescent ; Adult ; Drugs, Chinese Herbal ; adverse effects ; Female ; Hepatic Veins ; diagnostic imaging ; pathology ; Hepatic Veno-Occlusive Disease ; diagnosis ; etiology ; pathology ; Humans ; Image Processing, Computer-Assisted ; methods ; Liver ; diagnostic imaging ; pathology ; Magnetic Resonance Imaging ; Male ; Middle Aged ; Portal Vein ; diagnostic imaging ; pathology ; Retrospective Studies ; Tomography, X-Ray Computed ; methods ; Young Adult

OBJECTIVE: To describe the CT and MRI features of hepatic sinusoidal obstruction syndrome (HSOS) caused by herbal medicine Gynura segetum. MATERIALS AND METHODS: The CT and MRI features of 16 consecutive Gynura segetum induced HSOS cases (12 men, 4 women) were analyzed. Eight patients had CT; three patients had MRI, and the remaining five patients had both CT and MRI examinations. Based on their clinical presentations and outcomes, the patients were classified into three categories: mild, moderate, and severe. The severity of the disease was also evaluated radiologically based on the abnormal hepatic patchy enhancement in post-contrast CT or MRI images. RESULTS: Ascites, patchy liver enhancement, and main right hepatic vein narrowing or occlusion were present in all 16 cases. Hepatomegaly and gallbladder wall thickening were present in 14 cases (87.5%, 14/16). Periportal high intensity on T2-weighted images was present in 6 cases (75%, 6/8). Normal liver parenchymal enhancement surrounding the main hepatic vein forming a clover-like sign was observed in 4 cases (25%, 4/16). The extent of patchy liver enhancement was statistically associated with clinical severity classification (kappa = 0.565). CONCLUSION: Ascites, patchy liver enhancement, and the main hepatic veins narrowing were the most frequent signs of herbal medicine induced HSOS. The grade of abnormal patchy liver enhancement was associated with the clinical severity.
Adult ; Aged ; Ascites/diagnosis ; Asteraceae/chemistry ; Cholecystography ; Female ; Gallbladder/pathology ; Hepatic Veins/pathology/radiography ; Hepatic Veno-Occlusive Disease/chemically induced/*diagnosis ; Hepatomegaly/diagnosis ; Humans ; *Magnetic Resonance Imaging ; Male ; Middle Aged ; Phytotherapy/*adverse effects ; Pyrrolizidine Alkaloids/adverse effects ; Severity of Illness Index ; *Tomography, X-Ray Computed ; Young Adult