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Veno‐occlusive disease of the liver in children following chemotherapy for acute myelocytic leukemia
Author(s) -
D'Cruz Cyril A.,
Wimmer Robert S.,
Theodore H.,
Huff Dale S.,
Naiman J. Lawrence
Publication year - 1983
Publication title -
cancer
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 3.052
H-Index - 304
eISSN - 1097-0142
pISSN - 0008-543X
DOI - 10.1002/1097-0142(19831115)52:10<1803::aid-cncr2820521007>3.0.co;2-d
Subject(s) - medicine , hepatosplenomegaly , liver biopsy , chemotherapy , hepatic veno occlusive disease , pathology , fulminant hepatic failure , biopsy , bone marrow , radiology , gastroenterology , disease , liver transplantation , hematopoietic stem cell transplantation , transplantation
Three children developed acute veno‐occlusive disease of the liver following combination chemotherapy for acute myelocytic leukemia. The clinical presentation was similar in all three, with acute onset of hepatomegaly and thrombocytopenia in the absence of significant transaminasemia or icterus. In all three patients, radionuclide imaging with technetium‐99m sulfur colloid showed hepatosplenomegaly, decreased liver uptake, and increased splenic activity. The results of liver biopsy established the diagnosis, revealing marked centrilobular congestion with hemorrhage into the spaces of Disse, atrophy of central hepatic cords, and edema of the walls of the central and sublobular veins. Each patient showed marked improvement following temporary cessation of chemotherapy. The diagnosis of veno‐occlusive disease is suggested by the triad of: (1) clinical signs and symptoms; (2) scintigraphic findings; and (3) temporal relationship to chemotherapy.