Low molecular weight heparin in the treatment of pyrrolizidine alkaloid-induced hepatic sinusoidal obstruction syndrome: five case reports

Autor: Minjie Jiang, Luyuan Wang, Xiaodong Du, Miaomiao Hao, Pujun Gao
Jazyk: angličtina
Rok vydání: 2020
Předmět:
Zdroj: Journal of International Medical Research, Vol 48 (2020)
Druh dokumentu: article
ISSN: 1473-2300
03000605
DOI: 10.1177/0300060520961916
Popis: Hepatic sinusoidal obstruction syndrome (HSOS) can be caused by the intake of pyrrolizidine alkaloids (PAs). The disease has a high mortality rate, a poor prognosis and limited treatment options. Managing pyrrolizidine alkaloid-induced hepatic sinusoidal obstruction syndrome (PA-HSOS) is a significant challenge for hepatologists. This case report describes five patients with PA-HSOS that were treated with low molecular weight heparin (LMWH) between 2014 and 2019. All five patients had a history of taking PA-containing herbal preparations before the onset of the disease. They all met the Nanjing diagnostic criteria and were diagnosed with PA-HSOS. Symptomatic treatment was administered to all five patients. In addition to symptomatic treatment, all five patients were treated with LMWH for approximately 8–21 days. After treatment, their ascites disappeared, symptoms improved and the hepatic venous blood flow had improved compared with before treatment. There was no obvious discomfort during the 6 months of follow-up. LMWH may play a useful role in the early treatment of PA-HSOS. Therefore, for patients in the early stages of PA-HSOS, in addition to symptomatic treatment, early anticoagulant intervention can be attempted to improve patient prognosis under close monitoring of coagulation.
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