scholarly journals Expert consensus on the clinical management of pyrrolizidine alkaloid‐induced hepatic sinusoidal obstruction syndrome

2019 ◽  
Vol 34 (4) ◽  
pp. 634-642 ◽  
Author(s):  
Yuzheng Zhuge ◽  
Yulan Liu ◽  
Weifen Xie ◽  
Xiaoping Zou ◽  
Jianming Xu ◽  
...  
Keyword(s):  
Clinical Management ◽  
Pyrrolizidine Alkaloid ◽  
Expert Consensus ◽  
Sinusoidal Obstruction Syndrome ◽  
Hepatic Sinusoidal Obstruction Syndrome

Proteomic Study of Pyrrolizidine Alkaloid-Induced Hepatic Sinusoidal Obstruction Syndrome in Rats

2015 ◽  
Vol 28 (9) ◽  
pp. 1715-1727 ◽  
Author(s):  
Yan-Hong Li ◽  
William Chi-Shing Tai ◽  
Jun-Yi Xue ◽  
Wing-Yan Wong ◽  
Cheng Lu ◽  
...  
Keyword(s):  
Pyrrolizidine Alkaloid ◽  
Sinusoidal Obstruction Syndrome ◽  
Hepatic Sinusoidal Obstruction Syndrome ◽  
Proteomic Study

First evidence of pyrrolizidine alkaloid N-oxide-induced hepatic sinusoidal obstruction syndrome in humans

2017 ◽  
Vol 91 (12) ◽  
pp. 3913-3925 ◽  
Author(s):  
Mengbi Yang ◽  
Jianqing Ruan ◽  
Hong Gao ◽  
Na Li ◽  
Jiang Ma ◽  
...  
Keyword(s):  
Pyrrolizidine Alkaloid ◽  
Sinusoidal Obstruction Syndrome ◽  
Hepatic Sinusoidal Obstruction Syndrome

scholarly journals Timing and efficacy of transjugular intrahepatic portosystemic shunt in patients with pyrrolizidine alkaloid-induced hepatic sinusoidal obstruction syndrome

2021 ◽  
Vol 11 (1) ◽  
Author(s):  
Fan Wu ◽  
Jiao Yu ◽  
Hongying Gan ◽  
Heng Zhang ◽  
Deying Tian ◽  
...  
Keyword(s):  
Internal Medicine ◽  
Chronic Illness ◽  
Transjugular Intrahepatic Portosystemic Shunt ◽  
Pyrrolizidine Alkaloid ◽  
Specific Treatment ◽  
Portosystemic Shunt ◽  
Sinusoidal Obstruction Syndrome ◽  
Short Term ◽  
Hepatic Sinusoidal Obstruction Syndrome ◽  
Intrahepatic Portosystemic Shunt

AbstractThere is no specific treatment for pyrrolizidine alkaloid-induced hepatic sinusoidal obstruction syndrome (PA-HSOS). It is not clear when transjugular intrahepatic portosystemic shunt (TIPS) should be implemented in PA-HSOS patients. This study aimed to evaluate the timing of TIPS using total bilirubin (TBIL) as a measure, and to investigate efficacy of TIPS. We retrospectively analyzed the medical records of 10 PA-HSOS patients, among whom 4 patients had received TIPS (TIPS group), and the remaining patients were assigned to the internal medicine group. In the TIPS group, the TBIL level before TIPS was 84.4 ± 45.2 µmol/L (> 3 mg/dL), and TBIL levels were increased to different degrees after TIPS. With the extension of time, serum TBIL levels gradually decreased, and no liver failure occurred. With regards to the short-term outcomes, 3 patients recovered, 1 developed chronic illness and 0 died in the TIPS group. Moreover, 0 patients recovered, 5 developed chronic illness and 1 died in the internal medicine group. The rank sum test of group design revealed significant differences in clinical outcomes (P = 0.02). It was suggested that when the internal medicine effect of PA-HSOS patients is poor, TIPS should be considered, which is no trestricted to the limit of 3 mg/dL TBIL. It was also found TIPS effectively promote the recovery of liver function and reduce the occurrence of chronicity.

scholarly journals Hepatic sinusoidal obstruction syndrome caused by the ingestion of Gynura segetum in a patient with alcoholic cirrhosis: a case report

2021 ◽  
Vol 49 (4) ◽  
pp. 030006052098064
Author(s):  
Panpan Cen ◽  
Jiexia Ding ◽  
Jie Jin
Keyword(s):  
Histopathological Examination ◽  
Early Stage ◽  
Pyrrolizidine Alkaloid ◽  
Chinese Herb ◽  
Anticoagulation Therapy ◽  
Herbal Medicines ◽  
Alcoholic Cirrhosis ◽  
Sinusoidal Obstruction Syndrome ◽  
Hematopoietic Stem ◽  
Hepatic Sinusoidal Obstruction Syndrome

Hepatic sinusoidal obstruction syndrome (HSOS) is a rare hepatic vascular disorder characterized by intrahepatic congestion, liver injury, and post-sinusoidal portal hypertension, and it is frequently associated with hematopoietic stem cell transplantation. In this study, we observed a case of HSOS associated with the ingestion of Gynura segetum, a pyrrolizidine alkaloid (PA)-containing Chinese herb, in a patient with alcoholic cirrhosis. The patient was a 43-year-old man with chief complaints of physical asthenia and a loss of appetite for more than a month. The diagnosis of HSOS combined with alcoholic cirrhosis was confirmed via the histopathological examination of liver tissues. With proper supportive and symptomatic care and anticoagulation therapy using low-molecular-weight heparin, the patient’s condition was stabilized. Because of its nonspecific symptoms in the early stage and a lack of information about PA consumption, PA-induced HSOS (PA-HSOS) has been long neglected, especially in patients with underlying liver diseases. Early identification and intervention are critical for optimizing outcomes. Further efforts are needed to supervise the use of PA-containing herbal medicines and identify accurate biomarkers for PA-HSOS.

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