Computed tomography findings of hepatic veno-occlusive disease caused by Sedum aizoon with histopathological correlation

This study investigated the value of computed tomography (CT) in the diagnosis and treatment of hepatic veno-occlusive disease (HVOD) caused by Sedum aizoon (SA). The clinical manifestations, treatment results, imaging findings, and histological findings of the liver were analyzed in 39 patients with HVOD caused by SA. Hepatomegaly, liver dysfunction, abdominal effusion, and geographic density changes on liver CT scans were found in all 39 patients. The pathological findings of histological liver examination included swelling and point-like necrosis of liver cells, significant expansion and congestion of the sinuses, endothelial swelling, and wall thickening with incomplete lumen occlusion of small liver vessels. CT geographic density changes were confirmed by histological examination of the liver in 18 patients. Sixteen patients with small amounts of ascites that started within 4 weeks of treatment recovered completely or significantly improved after symptomatic and supportive treatment. However, only 43.75% of the patients with larger amounts of ascites improved following symptomatic and supportive treatment. In conclusion, liver CT examination is a valuable, safe, and noninvasive tool for the diagnosis of HVOD caused by SA. In selected cases, liver CT examination may replace liver biopsy and histological analysis.

Early gastrointestinal complications of stem cell transplant - results of prospective study at IRCH AIIMS, India

The study was conducted with the purpose of finding clinical profile of early gastrointestinal complications of stem cell transplant at this center. 70 consecutive subjects, who were subject to bone marrow transplant from October 2002 to September 2004, were prospectively studied. The gastrointestinal complications were followed in first 100 days of transplant and recorded in a pre-determined format. Study population comprised of 23 allo-transplant [with 3-non-myelablative procedures] and 47 auto-transplant subjects. Gastrointestinal complications included: nausea and vomiting occurred in 19 [82.60%], mucositis-20 [86.95%], diarrhea- 15% [65.12%], veno-occlusive disease [VOD] - 3 [13.04%] and acute pancreatitis- 1 [4.34%] in allo transplant group. Nausea and vomiting occurred 36 [76.59%], mucositis-46 [97.88%] diarrhea-39 [82.98%], VOD-5 [10.64%] in auto-transplant subjects. Acute graft versus host disease [AGVHD] involved gut in 3 and liver in 1 case of allo-BMT-group

Prophylactic Low-dose Heparin or Prostaglandin E1 may Prevent Severe Veno-occlusive Disease of the Liver after Allogeneic Hematopoietic Stem Cell Transplantation in Korean Children

Studies investigating the effect of prophylactic drugs on hepatic veno-occlusive disease (VOD) development are rare in children that have undergone allogeneic hematopoietic stem cell transplantation (HSCT). This study examined risk factors for VOD, the effect of prophylactic low-dose heparin or lipo-prostaglandin E1 (lipo-PGE1) and the survival rate at day +100 in children undergoing allogeneic HSCT. Eighty five children underwent HSCT between June 1997 and September 2004. Patients were diagnosed and classified as having mild, moderate or severe VOD according to Seattle clinical criteria. Among 85 patients, 25 (29%) developed VOD. VOD occurred more frequently in patients receiving busulfan-based conditioning (24/65, 37%) than in those receiving TBI-based (1/10, 10%) or other (0/10, 0%) regimens (p<0.05). The incidence of VOD was lower in patients with non-malignant disease compared to those with malignant disease (p<0.05). Survival at day +100 for non-VOD patients was better than that for VOD patients (92% vs. 76%, p<0.05). No patients receiving prophylactic heparin or lipo-PGE1 were found to develop severe VOD, whereas 5 of 35 patients not receiving such prophylaxis developed severe VOD. Given severe VOD is associated with a high mortality rate, this study indicates that prophylactic heparin or lipo-PGE1 may decrease mortality in children undergoing HSCT.

outbreak of veno-occlusive disease of the liver in northern Iraq

This paper describes an outbreak of veno-occlusive disease of the liver which occurred in Mosul, northern Iraq in 1994. It was caused by the consumption of wheat accidentally contaminated with Senecio seeds which produced toxic pyrrolizidine alkaloids. The outbreak involved 14 people [eight males and six females] who were members of three Bedouin families. Half of the cases were under the age of 15 years. The striking clinical features were abdominal pain, rapidly filling ascites and hepatomegaly. Two deaths occurred during hospitalization, with an estimated case fatality rate of 14%

Enfermedad hepática veno-oclusiva asociada a la ingestión de humanrripa (senecio tephrosioides) / Hepatic veno-oclusive disease associated to ingetion of huamanrripa (senecio tephrosioides)

Se reporta un caso de enfermedad veno-oclusiva del hígado (EHVO) en una mujer de 38 años de edad que había consumido ocasionalmente "huamanrripa" (Senecio tephrosioides) durante algunos años como antitusígeno. Fue hospitalizada por presentar dolor abdominal difuso, ictericia y anasarca durante 10 semanas. El estudio histológico de la biopsia hepática mostró marcada congestión a predominio centrolobulillar, focos de necrosis y en algunas áreas, inversión de la arquitectura del lobulillo hepático. En los siguientes 13 meses ha sido hospitalizada en 4 ocasiones por complicaciones de hipertensión portal. Este es el primer caso reportado de enfermedad hepática veno-oclusiva asociada a la ingesta de S. tephrosioides. Es muy probable que esta planta usada en la medicina tradicional peruana contenga alcaloides pirrolizidina, sustancias hepato- y nefrotóxicas que estan presentes en otras especies del género Senecio. Debido a la popularidad actual de las medicinas alternativas se espera un aumento en la incidencia de EHVO