Hepatic venoocclusive disease

Hepatic venoocclusive disease (HVOD), also known as sinusoidal obstruction syndrome (SOS), is a condition characterized by the obstruction of small veins in the liver. This disease is often associated with chemotherapy and bone marrow transplant procedures, particularly in pediatric patients.

Etiology

The exact cause of HVOD is not fully understood. However, it is believed to be related to damage to the cells lining the small veins of the liver, leading to blockage and subsequent liver damage. This damage can be caused by certain medications, particularly high-dose chemotherapy drugs used in the treatment of cancer. Other potential causes include exposure to certain toxins, such as pyrrolizidine alkaloids, found in certain plants and herbs.

Symptoms

Symptoms of HVOD can vary in severity, but often include jaundice, ascites (fluid accumulation in the abdomen), and hepatomegaly (enlarged liver). In severe cases, the disease can lead to liver failure and death.

Diagnosis

Diagnosis of HVOD is often challenging due to the nonspecific nature of the symptoms. It is typically based on a combination of clinical symptoms, laboratory findings, and imaging studies. Liver biopsy is considered the gold standard for diagnosis, but it is often avoided due to the risk of complications.

Treatment

Treatment of HVOD is primarily supportive, focusing on managing symptoms and preventing complications. This may include fluid management, use of diuretics, and treatment of any underlying conditions. In severe cases, liver transplant may be considered.

Prognosis

The prognosis of HVOD varies widely, depending on the severity of the disease and the patient's overall health. With prompt diagnosis and treatment, many patients can recover fully. However, in severe cases, the disease can be fatal.

See also

• Liver disease
• Chemotherapy
• Bone marrow transplant

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