Hepatic Sinusoidal Obstruction Syndrome: All You Need to Know [Symyptoms, Causes, & Treatment]

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Hepatic Sinusoidal Obstruction Syndrome: All You Need to Know [Symyptoms, Causes, Treatment] 

This article is about hepatic sinusoidal obstruction syndrome or veno-occlusive disease so before going towards it let’s get a little overview of the liver. The liver is an organ only present in all vertebrates. The function of the liver is to detoxify numerous metabolites, incorporate proteins, and make biochemicals required for digestion and growth. It is located in the right upper quadrant of the human below the diaphragm. It is a large organ. The weight is about 3 pounds. If this medical condition is diagnosed by any of your family members and you don’t know about that so don’t panic. We will provide each thing in the very simplest form. STAY TUNED!

What is Hepatic Sinusoidal Obstruction Syndrome?

It is an unusual medical condition for the layman. It is a life-threatening condition for the patient. Hepatic sinusoidal obstruction syndrome is the blockage of the very small veins in the liver. It is also known as a veno-occlusive disease (VOD), the hepatic sinusoidal obstruction syndrome can happen at any age and is a well-recognized issue of hematopoietic stem cell transplantation and presents significant morbidity and mortality. 

What Are The Causes?

Hepatic sinusoidal obstruction syndrome can present in an acute, subacute or chronic form. VOD veno-occlusive disease or Hepatic sinusoidal obstruction syndrome is a notable problem of hematopoietic stem cell transplantation, both allogeneic and autologous. It is categorized as conditioning-related toxicity. The occurrence of this disease differs from less than 5% to as high as 70% in various reports. Following are the causes of Hepatic sinusoidal obstruction syndrome.

  • Uptake of pyrrolizidine alkaloids is observed in crotalaria and Senecio plants and in other herbs such as comfrey. It is used to make tea. 
  • Use of several drugs that sometimes have noxious impacts on the liver, including cyclophosphamide and azathioprine.
  • Radiation therapy to suppress the immune system before stem cell transplantation. 
  • Reaction after bone marrow or stem cell transplantation

What Are The Symptoms?

The Hepatic sinusoidal obstruction syndrome symptoms might be onset and cause an emergency condition for you but the symptoms usually seem near the end of the first week or starting of the second week after transplantation Let’s have a look at the symptoms of Hepatic sinusoidal obstruction syndrome or veno-occlusive disease below;

  • Abdominal pain
  • Swelling
  • Weight gain
  • Ascites 
  • Edema
  • Varices
  • Jaundice (mild)
  • Muscle wasting
  • Weakness

What Are The Risk Factors?

It is generally considered that the risk of Hepatic sinusoidal obstruction syndrome or veno-occlusive disease is higher in patients who undergo allogeneic stem cell transplantation (transferring the stem cells from a healthy person’s body to the patient’s body). The risk is lower in patients who undergo autologous stem cell transplantation. 

What is The Diagnosis?

Doctors suspect sinusoidal obstruction syndrome based on symptoms of the clinical evaluation or blood test results that imply liver dysfunction, especially if people have ingested stuff or have conditions that may cause the disease. Following are the diagnosis of Hepatic sinusoidal obstruction syndrome or veno-occlusive disease;

  • Evaluation
  • Blood test
  • Doppler ultrasonography
  • Liver biopsy

These tests include a liver biopsy or computation of blood pressure in the hepatic veins and portal vein although most of the time the doppler ultrasound confirms the diagnosis of the disease. 

What is The Treatment?

There is no particular treatment for this disease but treatment usually involves supportive care including shock control and possibly diuretics. In patients with the severe condition due to a bone marrow transplant, defibrotide is a recommended treatment. Give assistance for complications such as hypotension, electrolyte and acid-base imbalance, renal and pulmonary failure, and infectious complications.


What is The Prevention?

Prevention of Hepatic sinusoidal obstruction syndrome or veno-occlusive disease is more possible to be effective than application of therapies after the injury has happened. Most essential is the evaluation of the probability of disease and practice of chemotherapies and conditioning process with lower rates of this complication in patients at the highest risk. 

Conclusive Thoughts

Hepatic sinusoidal obstruction syndrome or veno-occlusive disease is a life-threatening condition for the patient. It occurs mostly in the patient with the stem cell transplantation. The symptoms include swelling, abdominal pain, edema and enlargement of the liver, etc. The most common diagnosis of this condition is doppler ultrasound. There is no specific treatment except pain management. 

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