Hepatic Veno-Occlusive Disease in a Case of Polymyositis Associated with Thrombotic Thrombocytopenic Purpura/hemolytic Uremic Syndrome.

Ishida, Yoh-ichi; Utikoshi, Manabu; Kurosaki, Masao; Ohta, Katuroh; Chujo, Tatsuya; Aoyama, Shou; Ohsawa, Kenzo; Saito, Katsuhiko; Yokoyama, Hitoshi; Ohta, Satoshi

doi:10.2169/internalmedicine.37.694

Cited by 12 publications

(4 citation statements)

References 18 publications

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“…Two VOD cases in infants who had not taken any medication have been previously reported [11]. Meanwhile, adult VOD cases as complications of thrombotic thrombocytopenic purpura (TTP) and hemophagocytic syndrome (HPS) without taking medication have been reported [12,13]. …”

Section: Discussionmentioning

confidence: 99%

Two difficulty diagnosis cases of severe veno-occlusive disease

et al. 2013

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BackgroudThe occurrence of Hepatic veno-occlusive disease (VOD) is rale liver disease. However, severe VOD is often lethal and one of the most common causes of death following stem cell transplantation (SCT).Case Reports:Case 1 was a 30-year-old woman who was diagnosed as Budd-Chiari syndrome with liver failure. She was admitted to our department to undergo liver transplantation. Four days after admission, she underwent liver transplantation. Her liver explant showed VOD. Case 2 was a 74-year-old woman who was admitted to a community hospital for further examination. Her condition continued to deteriorate with liver failure, and she died 39 days after admission. Liver autopsy also showed VOD. Either of the patients had difficulty in diagnose as VOD. Neither of the patients had a history of SCT.Conclusions:VOD should be considered as a cause of acute hepatic failure, even if the patient has no history of SCT.

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Section: Discussionmentioning

confidence: 99%

Two difficulty diagnosis cases of severe veno-occlusive disease

et al. 2013

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“…To our knowledge, there has been only one case report of ascites in a patient with TMA. Ishida et al described a case of polymyositis complicated by TTP/HUS in which considerable ascites appeared and hepatic venoocclusive disease (VOD)-like pathological changes were found during autopsy (11). The clinical diagnosis of hepatic VOD is based on the presence of a triad of symptoms: painful hepatomegaly, hyperbilirubinemia, and unexplained fluid retention (12).…”

Section: Discussionmentioning

confidence: 99%

Thrombotic Microangiopathy Presenting with a Considerable Accumulation of Ascites: A Case Report

et al. 2011

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A 46-year-old man presented with fever, thrombocytopenia, and a considerable accumulation of ascites. Although prednisolone and intravenous cyclophosphamide pulse (IVCY) were effective, he experienced recurrence. Renal insufficiency and hemolytic anemia developed subsequently. Schistocytes, negative Coombs' test, and elevated lactate dehydrogenase levels indicated thrombotic microangiopathy (TMA). He recovered well after receiving plasma infusion, IVCY, and prednisolone. Renal biopsy revealed subendothelial widening, thereby confirming TMA. This is a very rare case of TMA that presented with a considerable volume of ascites.

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“…SOS/VOD was reported in 7.3% of 275 patients with HIV/AIDS, and was statistically related to intravenous drug abuse in these patients. 46 In addition to drugs and toxins, the literature search yielded 2 cases of SOS/VOD in ataxia telangiectasia, 47 and a case report each of SOS/VOD associated with systemic lupus erythromatosus, 48 allergic granulomatous angiitis, 49 polymyositis with TTP/HUS, 50 and hypereosinophilic syndrome. 51 In liver allografts, SOS/VOD has been reported as a manifestation of acute rejection.…”

Section: Sinusoidal Obstruction Syndrome/veno-occlusive Diseasementioning

confidence: 99%

“…In addition to drugs and toxins, the literature search yielded 2 cases of SOS/VOD in ataxia telangiectasia,47 and a case report each of SOS/VOD associated with systemic lupus erythromatosus,48 allergic granulomatous angiitis,49 polymyositis with TTP/HUS,50 and hypereosinophilic syndrome 51…”

Section: Sinusoidal Obstruction Syndrome/veno-occlusive Diseasementioning

confidence: 99%

Role of the Surgical Pathologist in Diagnosis of Drug-induced Liver Injury: Recognizing Specific Patterns of Drug Injury

Chopra

Gawrieh

Vuppalanchi

et al. 2021

Advances in Anatomic Pathology

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Eighteen histologic patterns of drug-induced liver injury (DILI) are described, most of which are also seen in other commonly occurring acute and chronic liver diseases. However, certain patterns such as sinusoidal obstruction syndrome/veno-occlusive disease, "bland" cholestasis and cholestatic hepatitis are more often caused by drugs than other competing etiologies. Amiodarone, acetaminophen, anabolic androgenic steroids and estrogens, result in histologic patterns that are virtually diagnostic of the respective drug. Recognition of a DILI or drug specific injury pattern enables the clinician to focus on eliciting an appropriate history to identify the offending agent, which may otherwise be rare and not immediately apparent. Although drugs can mimic any and every liver disease, the mimicry is often imperfect. Unusual features that do not completely fit the clinicopathologic paradigm of the mimicked liver disease are clues to diagnosis of DILI. When mimicking a liver disease, drugs tend to hasten or accelerate the natural progression of the disease. Novel immunomodulatory drugs for inflammatory disorders and cancer may cause unintended effects on the immune system, resulting in immune-related side effects. The role of the pathologist in diagnosis of DILI is to recognize known patterns of DILI, and either confirm a diagnosis when clinically suspected, or alert the clinician to the possibility of DILI when it is not suspected. The latter is particularly vital in contemporary practice, which is witnessing an accelerated pace of drug development, and a surge in consumption of nutritional supplements and herbal compounds by an increasingly health conscious society.

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Hepatic Veno-Occlusive Disease in a Case of Polymyositis Associated with Thrombotic Thrombocytopenic Purpura/hemolytic Uremic Syndrome.

Cited by 12 publications

References 18 publications

Two difficulty diagnosis cases of severe veno-occlusive disease

Two difficulty diagnosis cases of severe veno-occlusive disease

Thrombotic Microangiopathy Presenting with a Considerable Accumulation of Ascites: A Case Report

Role of the Surgical Pathologist in Diagnosis of Drug-induced Liver Injury: Recognizing Specific Patterns of Drug Injury

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