For Publishers
DiscoveryMetadataPeer reviewHostingPublishing
For Researchers
JoinPublishReviewCollect
Register
Blog
About
Search
Advanced search
My ScienceOpen
Search
For Publishers
For Researchers
Blog
About
12
views
11
references
 Top references
cited by
1
    
0 reviews
 Review
0
comments
 Comment
0
recommends
+1 Recommend
0 collections
    0
    shares
      646
      similar
       All similar
      • Record: found
      • Abstract: found
      • Article: found
      Is Open Access

      Hepatic veno-occlusive disease related to Gynura segetum : A case report

      case-report
      Author(s): , MS a , b , , MS c , , MD a , ∗
      Editor(s):
      Publication date (Electronic):
      Journal: Medicine
      Publisher: Wolters Kluwer Health
      Keywords: Gynura segetum, hepatic veno-occlusive disease, ultrasonography of liver

      Read this article at

      ScienceOpenPublisherPMC
      Bookmark
          There is no author summary for this article yet. Authors can add summaries to their articles on ScienceOpen to make them more accessible to a non-specialist audience.

          Abstract

          Introduction:

          Hepatic veno-occlusive disease (HVOD), as known as hepatic sinusoidal obstruction syndrome (HSOS), is an obliterative venulitis of the terminal hepatic venules, which is responsible for considerable mortality. The potential mechanism is destruction of hepatic sinusoidal endothelial cells (SEC), with sloughing and downstream occlusion of terminal hepatic venules. Here, we report a case of HVOD who have a history of ingestion of Gynura segetum for 1 month. The patient presents for abdominal pain and distension. He was diagnosed for HVOD using computerized tomography (CT) and ultrasonography of liver. And then best supportive care was added. However, without liver transplantation for financial reason, he died in 1 month after discharged from hospital.

          Conclusions:

          We think portal flow reversal was a characteristic imaging findings of HVOD, which can be listed as a specific diagnostic criterion of HVOD. Once the condition was worsening, liver transplantation should be considered as the first choice of treatment planning.

          Related collections

          Most cited references11

          • Record: found
          • Abstract: found
          • Article: not found

          Sinusoidal obstruction syndrome (hepatic veno-occlusive disease).

          Cathy Q Fan, James M Crawford (2014)
          Hepatic sinusoidal obstruction syndrome (SOS) is an obliterative venulitis of the terminal hepatic venules, which in its more severe forms imparts a high risk of mortality. SOS, also known as veno-occlusive disease (VOD), occurs as a result of cytoreductive therapy prior to hematopoietic stem cell transplantation (HSCT), following oxaliplatin-containing adjuvant or neoadjuvant chemotherapy for colorectal carcinoma metastatic to the liver and treated by partial hepatectomy, in patients taking pyrrolizidine alkaloid-containing herbal remedies, and in other particular settings such as the autosomal recessive condition of veno-occlusive disease with immunodeficiency (VODI). A central pathogenic event is toxic destruction of hepatic sinusoidal endothelial cells (SEC), with sloughing and downstream occlusion of terminal hepatic venules. Contributing factors are SEC glutathione depletion, nitric oxide depletion, increased intrahepatic expression of matrix metalloproteinases and vascular endothelial growth factor (VEGF), and activation of clotting factors. The clinical presentation of SOS includes jaundice, development of right upper-quadrant pain and tender hepatomegaly, ascites, and unexplained weight gain. Owing to the potentially critical condition of these patients, transjugular biopsy may be the preferred route for liver biopsy to exclude other potential causes of liver dysfunction and to establish a diagnosis of SOS. Treatment includes rigorous fluid management so as to avoid excessive fluid overload while avoiding too rapid diuresis or pericentesis, potential use of pharmaceutics such as defibrotide, coagulolytic agents, or methylprednisolone, and liver transplantation. Proposed strategies for prevention and prophylaxis include reduced-intensity conditioning radiation for HSCT, treatment with ursodeoxycholic acid, and inclusion of bevacizumab with oxaliplatin-based chemotherapeutic regimes. While significant progress has been made in understanding the pathogenesis of SOS and in mitigating against its adverse outcomes, this condition remains a serious complication of a selective group of medical treatments.
          Article 0 comments Cited 96 times – based on 0 reviews     Review now
            Bookmark
            • Record: found
            • Abstract: found
            • Article: not found

            Hepatic sinusoidal obstruction syndrome associated with consumption of Gynura segetum.

            Feng Wang, Ge Lin, Yan Zhou … (2011)
            One major cause of hepatic sinusoidal obstruction syndrome (HSOS) is the intake of pyrrolizidine alkaloid (PA)-containing products. Over 8000 PA-induced HSOS cases have been reported worldwide and at least 51 among them were suspected to be attributed to exposure to the Chinese medicine 'Tusanqi'. PA-induced hepatotoxicity involves cytochrome P450-mediated metabolic activation of PAs to electrophilic pyrrolic metabolites which react with macromolecules, such as proteins. However, no studies have found such protein adduction in HSOS patients. We report one HSOS case confirmed by liver biopsy, where the patient claimed taking 'Tusanqi' as self-medication. The herb was analyzed by HPLC-MS, and its induced hepatotoxicity in rats was assessed by monitoring the alteration of serum ALT level and liver morphology. Blood pyrrole-protein adducts were determined by UPLC-MS. The herb the patient consumed was identified as Gynura segetum, an erroneous substitute of non-PA-containing Sedum aizoon, called 'Tusanqi'. Hepatotoxic PAs senecionine and seneciphylline were detected in G. segetum. In the PA-exposed patient, serum pyrrole-protein adducts were detected by a newly developed analytical approach. The animal study showed a good correlation of liver injury with the ingestion of G. segetum. For the first time, serum pyrrole-protein adducts were unequivocally detected in a PA-induced HSOS patient, and such adducts show a potential to be developed as a biomarker for the assessment of PA-induced HSOS. Similar to the well-known case of aristolochic acid-poisoning, the observed HSOS was confirmed to arise from the consumption of PA-containing G. segetum, an erroneous substitute of non-PA-containing S. aizoon. Copyright © 2010 European Association for the Study of the Liver. Published by Elsevier B.V. All rights reserved.
            Article 0 comments Cited 77 times – based on 0 reviews     Review now
              Bookmark
              • Record: found
              • Abstract: not found
              • Article: not found

              Herbal medicine hepatotoxicity: a new step with development of specific biomarkers.

              Dominique Larrey, Stéphanie Faure (2011)
              Article 0 comments Cited 18 times – based on 0 reviews     Review now
                Bookmark
                All references

                Author and article information

                Journal
                Journal ID (nlm-ta): Medicine (Baltimore)
                Journal ID (iso-abbrev): Medicine (Baltimore)
                Journal ID (publisher-id): MEDI
                Title: Medicine
                Publisher: Wolters Kluwer Health
                ISSN (Print): 0025-7974
                ISSN (Electronic): 1536-5964
                Publication date Collection: April 2018
                Publication date (Electronic): 27 April 2018
                Volume: 97
                Issue: 17
                Electronic Location Identifier: e0552
                Affiliations
                [a ]Department of Medical Oncology, Lung Cancer and Gastrointestinal Unit, Hunan Cancer Hospital, the Affiliated Cancer Hospital of Xiangya School of Medicine
                [b ]Graduate Schools, Central South University,
                [c ]The Second Xiangya Hospital of Central South University, Changsha, China.
                Author notes
                [∗ ]Correspondence: Yongchang Zhang, Department of Medical Oncology, Lung Cancer, and Gastrointestinal Unit, Human Cancer Hospital, the Affiliated Cancer Hospital of Xiangya School of Medicine, Changsha, China 410005 (e-mail: zhangyongchang@ 123456csu.edu.cn ).
                Article
                Publisher ID: MD-D-17-08166 Accession ID: 00552
                DOI: 10.1097/MD.0000000000010552
                PMC ID: 5944499
                PubMed ID: 29703039
                SO-VID: 33108678-5c28-4169-ba95-7be8362f800f
                Copyright © Copyright © 2018 the Author(s). Published by Wolters Kluwer Health, Inc.
                License:

                This is an open access article distributed under the terms of the Creative Commons Attribution-Non Commercial-No Derivatives License 4.0 (CCBY-NC-ND), where it is permissible to download and share the work provided it is properly cited. The work cannot be changed in any way or used commercially without permission from the journal. http://creativecommons.org/licenses/by-nc-nd/4.0

                History
                Date received : 28 December 2017
                Date accepted : 3 April 2018
                Categories
                Subject: 4500
                Subject: Research Article
                Subject: Clinical Case Report
                Custom metadata
                OPEN-ACCESS TRUE

                Keywords: gynura segetum,hepatic veno-occlusive disease,ultrasonography of liver
                Data availability:
                Keywords: gynura segetum, hepatic veno-occlusive disease, ultrasonography of liver

                Comments

                Comment on this article