Gynura segetum, family Compositae, is a cultivated species and can be found growing in the tropical regions of Indonesia and Malaysia. The plant is known for . PDF | Gynura segetum (Lour.) Merr. (Compositae) is a well recognized medicinal plant in Indonesia and Malaysia. It is believed to have an anticoagulant effect. Hepatic veno-occlusive disease (HVOD) caused by Gynura segetum has been increasingly reported in China in recent years. The aim of this.
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Hepatic veno-occlusive disease HVODas known as hepatic sinusoidal obstruction syndrome HSOSis an obliterative venulitis of the terminal hepatic venules, which is responsible for considerable mortality. The potential mechanism is destruction of hepatic sinusoidal endothelial cells SECwith sloughing and downstream occlusion of terminal hepatic venules. The patient presents for abdominal pain and distension. And then best supportive care was added.
However, without liver transplantation for financial reason, he died in 1 month after discharged from hospital. Once the condition was worsening, liver transplantation should be considered as the first choice of treatment planning. Veno-occlusive disease of liver VODas known as hepatic sinusoidal obstruction syndrome SOSis an obliterative venulitis of the terminal hepatic venules, which serves as a high risk of mortality.
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A year-old male was enrolled in the Second Xiangya Hospital of Central South University on Mar 3,due to abdominal pain, abdominal distension, and loss gynuraa appetite for 1 week. To treat his traumatic injuries, the patient had taken large doses of Gynura segetum before he developed symptoms.
Physical examination revealed development of right upper-quadrant pain, ascites with shifting dullness, and unexplained weight gain. Laboratory tests showed that total albumin The results of laboratory tests indicated liver injury. CT showed that hepatomegaly and the number of hepatic veins was reduced Fig. Ultrasonography of liver showed that uniform distribution of parenchymal spot, less clear border, segeum intrahepatic vessels, abnormal liver blood flow distribution at the rate of 9.
Based on the history of Gynura segetum taking, typical clinical presentation, laboratory tests, the results of CT, and ultrasonography of liver, the patient was diagnosed with VOD.
However, the total bilirubin level, the direct bilirubin level and the total bile acid level were elevated to However, the total bilirubin level, the direct bilirubin level and the total bile acid level were significantly elevated to Gynurz to the worsening setetum, we suggested the patient to receive liver transplantation.
However, for the financial reasons, he failed to receive liver transplantation.
The follow-up data showed that he died in 1 month after discharged from hospital. The computerized tomography CT of liver was shown. The inferior segment of inferior vena cava was poorly filled A, B, red arrows ; the hepatic veins were not developed, and the liver parenchyma was uneven C, D, red arrows. The ultrasonography of liver A gynuta, star-shaped color B hynura, ascites C, Dand gallbladder wall edema E can be seen in the liver ultrasonography.
Gynura Segetum Herb Uses, Benefits, Cures, Side Effects, Nutrients
VOD of liver was first reported by Dr. It is often caused by high-dose chemotherapy before bone marrow transplantations and ingestion of pyrrolizidine alkaloids contained in herbal.
In China, Gynura segetum is regarded as a good herbal medicine, which has the main function of invigorating the circulation of blood to treat trauma. However, several articles reported that Gynura segetum has the hepatotoxicity component, namely pyrrolizidine alkaloids which could cause some special disease. HVOD described by Dr. Dai was associated with the ingestion of Gynura root containing pyrrolizidine alkaloids. Meanwhile, they also offered other common clinical examination methods to diagnose, such as laboratory tests, abdominal CT, digital subtraction angiography, ultrasonography, and so on.
In our case, for the refusal of patient, we failed to take liver biopsies. Despite all, with the clinical examinations and past reports about HVOD and Gynura segetumwe also made a reliable diagnosis for the patient. At present, apart from symptomatic methods, there was no specific treatment of HVOD. Hence, the key of the treatment of VOD should be symptomatic and rapid. When you receive a suspected case, you should pay more attention to monitoring of liver function, water-electrolyte balance, and infection control.
Dai mentioned transjugular intrahepatic portosystemic shunt TIPSan approach to decrease the effective hepatic vascular resistance by creating a shunt, which was not recommended for patients with HVOD. At the same time, preventive measures were also important for patients.
Hepatotoxic drugs and any plants containing pyrrolizidine alkaloids should be eegetum. In conclusion, a liver biopsy is needed to make a definitive diagnosis of HVOD. However, if we could not take liver biopsies in the clinical practice, we could depend on ultrasound to acquire characteristic imaging findings, such as ascites, hepatomegaly, and portal flow reversal and so on. Compared with other VOD patients, this case progressed urgently and the overall survival time was only 2 months.
So, early diagnosis is of importance to these patients whose disease progresses develop rapidly. We think that portal flow seetum is a characteristic imaging findings of HVOD, which provides useful information in our case and can be listed as a specific diagnostic criterion of HVOD.
Furthermore, early preventive measures, including liver transplantation, should be considered for patients to avoid liver segetun. This was a case report. Ethics committee or institutional review board approval was not obtained.
It was not necessary for the case gynua. The next of kin signed informed consent for the publication of this case report. The authors thank the next of kin for agreeing with our report and for providing a detailed medical history. We also thank all the 3 authors to collected data, draft the article, and finish the submission.
Yongchang Zhang designed the project. Ziyi Sun prepared the manuscript and Jianmei Kang collected the data. ZS and JK contributed equally to this work. The authors declare no conflicts of interest. National Center for Biotechnology InformationU.
Hepatic veno-occlusive disease related to Gynura segetum
Journal List Medicine Baltimore v. Published online Apr Find articles by Jianmei Kang.
Author information Article notes Copyright and License information Disclaimer. Received Dec 28; Accepted Apr 3.
Published by Wolters Kluwer Health, Inc. The work cannot be changed in any way or used commercially without permission segstum the journal. Gynura segetumhepatic veno-occlusive disease, ultrasonography of liver. Introduction Veno-occlusive disease of liver VODas known as hepatic sinusoidal obstruction syndrome SOSis an obliterative venulitis of the terminal hepatic venules, which serves as a high risk of mortality. Case description A year-old male seyetum enrolled in the Second Xiangya Hospital of Central South University on Mar 3,due to abdominal pain, srgetum distension, and loss of appetite for 1 week.
Open in a separate window. Discussion VOD of liver was first reported by Dr. Method This was a case report. Acknowledgments The authors thank the next of kin segethm agreeing with our report and for providing a detailed medical history. Author contributions Yongchang Zhang designed the project. Writing — original draft: Ziyi Sun, Jianmei Kang. Hepatic veno-occlusive disease with immunodeficiency. Hepatic veno-occlusive disease after taking Gynura Gynurra Hepatol Res ; Gynura root induces hepatic veno-occlusive disease: World J Gastroenterol ; J Hepatol ; Hepatic veno-occlusive disease due to pyrrolizidine Senecio segetun in Arizona.
Hepatic toxicity resulting from cancer treatment. Hepatic sinusoidal obstruction syndrome associated with consumption of Gynura segetum. Hepatic veno-occlusive disease during isavuconazole administration. J Chemother ; Detection of Sp by flow cytometry and application to screening patients for veno-occlusive disease with immunodeficiency. J Clin Immunol ; J Gastroenterol Hepatol ; Transjugular intrahepatic portosystemic shunting TIPS for treatment of severe hepatic veno-occlusive disease.