Question: Hepatic veno-occlusive disease (HVOD) has been reported as a complication of herbals that contain pyrrolizidine alkaloids. What are the clinical characteristics of hepatic veno-occlusive disease?
Answer: The cited article notes, “Hepatic veno-occlusive disease (HVOD) is a clinical syndrome characterized by hyperbilirubinemia, painful hepatomegaly and weight gain due to fluid retention, after hematopoietic stem cell transplantation (HSCT), HVOD is a well-recognized life threatening complication, with an incidence rate of 10% to 60%.” Similar clinical findings are reported following the ingestion of herbals containing pyrrolizidine alkaloids. The cited article cautions, “Confirmation of HVOD is based on the histology examination of liver tissue.” (Dai N et al. Gynura root induces hepatic veno-occlusive disease: A case report and review of the literature. 2007 World J Gastroenterol 13910): 1628-1631)