Hepatic sinusoidal obstruction syndrome associated with Tephroseris kirilowii
10.3760/cma.j.cn114015-20230130-00038
- VernacularTitle:狗舌草致肝窦阻塞综合征
- Author:
Wanqin ZHANG
1
;
Fang ZHU
Author Information
1. 南京医科大学附属宿迁第一人民医院急诊医学中心，宿迁 223800
- Publication Type:Journal Article
- Keywords:
Pyrrolizidine alkaloids;
Hepatic veno-occlusive disease;
Hepatic sinusoidal obstruction syndrome;
Tephroseris kirilowii;
Drug-induced liver injury
- From:
Adverse Drug Reactions Journal
2024;26(1):56-58
- CountryChina
- Language:Chinese
-
Abstract:
A 66-year-old male patient intermittently drank soading water of Tephroseris kirilowii by himself to alleviate skin itching caused by scabies. After nearly 2 years, he developed symptoms of abdominal distension, abdominal pain, poor appetite, and yellow urine. Laboratory tests showed total bilirubin (TBil) 158.2 μmol/L, direct bilirubin (DBil) 73.5 μmol/L, alanine aminotransferase (ALT) 96 U/L, aspartate aminotransferase (AST) 131 U/L, cholinesterase 1.40 kU/L, and international normalized ratio (INR) 1.7. Magnetic resonance imaging examination of upper abdomen showed consistent performance with the manifestation of hepatic sinusoidal obstruction syndrome. After excluding other causes, it was considered that it was caused by Tephroseris kirilowii. Supportive treatments such as anti-infection, liver protection, diuresis, nutritional support, anticoagulation, and reducing portal vein pressure were given. But the patient′s symptoms continue to worsen, with intermittent complications such as hepatic encephalopathy and gastrointestinal bleeding. After 67 days of treatments, laboratory tests showed TBil 192.0 μmol/L, DBil 96.7 μmol/L, ALT 118 U/L, AST 193 U/L, and cholinesterase 0.72 kU/L. The patient was discharged upon request from himself and the families, and died 5 days later.
