Abstract:

Objective Sinusoidal obstruction syndrome (SOS) is a clinical syndrome characterized by tender hepatomegaly, jaundice, and ascites, but not always easy to diagnose. This study aimed at summarizing several informative clinical presentations of SOS.Methods A total of 9 SOS cases seen from October 2009 to August 2014 were collected. Clinical materials including medical history, laboratory data, imaging features and outcomes were retrospectively analyzed.Results Majority of the 9 cases had a history of applying Chinese herbs before the onset of SOS. Most common clinical manifestations were bloating, right upper quadrant pain and weight gain. Biochemical tests revealed elevation of serum transaminase (especially AST>ALT) and hyperbilirubinemia. Serum-ascites albumin concentration gradient ≥11 g/L. Imaging examinations demonstrated hepatomegaly, inhomogeneous liver parenchyma and attenuated hepatic veins. Sinusoidal dilatation and hepatic cell necrosis were obvious in liver biopsy. Treatments were generally symptomatic and supportive. 2 cases of severe SOS died while the other 7 finally improved.Conclusion These 9 cases of SOS were mostly associated with Chinese herbs. Diagnosis was comprehensively based on clinical, laboratory, imaging and histological features. There were limited therapeutic options for SOS and severe cases had poor prognosis.

Key words: sinusoidal obstruction syndrome, hepatic veno-occlusive disease, Chinese herbs