Kawata S, Kiyonaga G, Seki K, Minami Y, Nishikawa M, Miyoshi S, Imai Y, Tarui S
Gastroenterol Jpn. 1981 Dec;16(6):616-22. doi: 10.1007/BF02813798.
A case of chronic veno-occlusive disease of the liver manifested by ascites in a 59-year-old Japanese male is described. The patient had not been exposed to pyrrolizidine alkaloids, but had been receiving allopurinol for hyperuricemia, the only drug taken throughout the period in which the hepatic lesion developed. The hepatic veins and inferior vena cava were patent according to angiography. The first biopsy showed histological characteristics of the disease and the following two biopsies demonstrated the progression of the hepatic lesion from central fibrosis to non-portal cirrhosis. Morphometric analysis of the sublobular and central veins in the three serial biopsy specimens demonstrated stepwise decrease of the ratio of the veins per portal triad and stepwise increase of severely obliterative veins.
本文描述了一例59岁日本男性以腹水为表现的慢性肝静脉闭塞病。该患者未接触过吡咯里西啶生物碱，但一直在接受别嘌醇治疗高尿酸血症，在肝脏病变发生期间这是唯一服用的药物。血管造影显示肝静脉和下腔静脉通畅。首次活检显示了该病的组织学特征，随后的两次活检显示肝脏病变从中央纤维化发展为非门脉性肝硬化。对三个连续活检标本中的小叶下静脉和中央静脉进行形态计量分析，结果显示每个门管区静脉比例呈逐步下降，严重闭塞静脉呈逐步增加。
