Background: One major etiology of hepatic sinusoidal obstruction syndrome (HSOS) in China is the intake of\npyrrolizidine alkaloids (PAs). Since PAs-induced HSOS is a rare disease that has not been clearly characterized until\nnow, the aim of this study was to investigate clinical characteristics, CT features, and pathological findings of PAinduced\nHSOS.\nMethods: This retrospective cohort study included 116 patients with PAs-induced HSOS and 68 patients with\nBudd-Chiari syndrome from Jan 2006 to Sep 2016. We collected medical records of the patients, and reviewed\nimage features of CT, and analyzed pathological findings.\nResults: Common clinical manifestations of PAs-induced HSOS were abdominal distention (98.26%), ascites (100%),\njaundice (52.94%), abdominal pain (36.36%). Abnormal liver function was observed in most of PAs-induced HSOS.\nOn CT scan, common findings included: ascites, hepatomegaly, the thickening of gallbladder wall, pleural effusion,\npatchy liver enhancement, and heterogeneous hypoattenuation. Most of the patients had a low ascitic total protein\n(< 25 g/L) and a high SAAG.In acute stage, pathologic features were massive sinusoidal dilatation,\nsinusoidal congestion, the extravasation of erythrocytes, hepatocellular necrosis, the accumulation of macrophages,\nthe deposition of hemosiderin. In subacute stage, complete loss of pericentral hepatocytes, sinusoidal dilatation, the\ndeposition of pigment granules were observed.\nConclusions: The PAs-induced HSOS patients displayed distinct clinical characteristics, imaging features, and\npathological findings, which provided some evidences for the diagnosis of PAs-induced HSOS.\nTrial registration: ChiCTR-DRD-17010709.
Loading....