Yeong M L, Swinburn B, Kennedy M, Nicholson G
Department of Pathology, Auckland Hospital, New Zealand.
J Gastroenterol Hepatol. 1990 Mar-Apr;5(2):211-4. doi: 10.1111/j.1440-1746.1990.tb01827.x.
A 23 year old man presented with hepatic veno-occlusive disease and severe portal hypertension and subsequently died from liver failure. Light microscopy and hepatic angiography showed occlusion of sublobular veins and small venous radicles of the liver, associated with widespread haemorrhagic necrosis of hepatocytes. The patient had been on a predominantly vegetarian diet and, prior to his illness, took comfrey leaves which are known to contain hepatotoxic pyrrolizidine alkaloids. Comfrey is widely used as a herbal remedy, but so far has only been implicated in two other documented cases of human hepatic veno-occlusive disease. A possible causal association of comfrey and this patient's veno-occlusive disease is suggested by the temporal relationship of the ingestion of comfrey to his presentation, the histological changes in the liver and the exclusion of other known causes of the disease.
一名23岁男性出现肝静脉闭塞病和严重门静脉高压，随后死于肝衰竭。光镜检查和肝血管造影显示肝小叶下静脉和小静脉分支闭塞，伴有肝细胞广泛出血性坏死。该患者以素食为主，患病前服用过已知含有肝毒性吡咯里西啶生物碱的紫草叶。紫草广泛用作草药，但迄今为止仅在另外两例有记录的人类肝静脉闭塞病病例中被牵连。紫草摄入与该患者发病的时间关系、肝脏的组织学变化以及排除该疾病的其他已知病因，提示紫草与该患者的静脉闭塞病可能存在因果关联。
