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'''''Synonyms and Keywords:''''' VOD, sinuosoidal obstruction syndrome
'''''Synonyms and Keywords:''''' VOD, sinuosoidal obstruction syndrome
==Overview==
==[[Veno-occlusive disease overview|Overview]]==
Veno-occlusive disease (VOD) is a disease of the liver in which the veins in the liver are obstructed or blocked.  VOD is a complication that occurs in up to 25% of [[bone marrow transplant]]ations, and may also occur after ingestion of certain plant [[alkaloids]].


==Pathophysiology==
==[[Veno-occlusive disease historical perspective|Historical Perspective]]==
VOD is also known as '''sinuosoidal obstruction syndrome''' due to obstruction of the venous system.  Following bone marrow transplantation, VOD has been hypothesized to be due to injury to the hepatic venous [[endothelium]] from the conditioning regimen.
==Prognosis==
When associated with bone marrow transplant, VOD is fatal in over 30% of cases. Cases due to plant alkaloids often have a longer and more unpredictable course.


==Diagnosis==
==[[Veno-occlusive disease classification|Classification]]==
===Symptoms===
 
*[[Weight gain]]
==[[Veno-occlusive disease pathophysiology|Pathophysiology]]==
*[[Right upper quadrant pain]] due to [[hepatomegaly]]
 
*[[Abdominal swelling]] due to [[ascites]]
==[[Veno-occlusive disease causes|Causes]]==
 
==[[Veno-occlusive disease differential diagnosis|Differentiating Veno-occlusive disease from other Diseases]]==
 
==[[Veno-occlusive disease epidemiology and demographics|Epidemiology and Demographics]]==
 
==[[Veno-occlusive disease risk factors|Risk Factors]]==
 
==[[Veno-occlusive disease screening|Screening]]==


===Physical Examination===
==[[Veno-occlusive disease natural history, complications and prognosis|Natural History, Complications and Prognosis]]==
====Abdominal Examination====
*Tender [[hepatomegaly]]
*[[Ascites]]


===Laboratory Studies===
==Diagnosis==
*Increased [[bilirubin]]
[[Veno-occlusive disease history and symptoms|History and Symptoms]] | [[Veno-occlusive disease physical examination|Physical Examination]] | [[Veno-occlusive disease laboratory findings|Laboratory Findings]] | [[Veno-occlusive disease biomarker_panel|Biomarker Panel]] | [[Veno-occlusive disease chest x ray|Chest X Ray]] | [[Veno-occlusive disease HLA_analysis|HLA Analysis]] | [[Veno-occlusive disease skin_punch_biopsy|Skin Punch Biopsy]] | [[Veno-occlusive disease ultrasound|Ultrasound]] | [[Veno-occlusive disease other imaging findings|Other Imaging Findings]] | [[Veno-occlusive disease other diagnostic studies|Other Diagnostic Studies]]
*[[Renal failure]] may be present


==Treatment==
==Treatment==
Treatment for VOD is primarily supportive. In the BMT setting, [[defibrotide]] is an investigational treatment that may be promising.  Defibrotide is a polydeoxyribonucleotide; its mechanism of benefit in VOD is unclear, but has been attributed to its antithromboitc properties.  
[[Veno-occlusive disease medical therapy|Medical Therapy]] | [[Veno-occlusive disease surgery|Surgery]] | [[Veno-occlusive disease primary prevention|Primary Prevention]] | [[Veno-occlusive disease secondary prevention|Secondary Prevention]] | [[Veno-occlusive disease cost-effectiveness of therapy|Cost-Effectiveness of Therapy]] | [[Veno-occlusive disease future or investigational therapies|Future or Investigational Therapies]]
 
==Sources==
Kumar, V., Abbas, A. and N. Fausto. 2004. ''Robbins & Cotran Pathologic Basis of Disease.'' Philadelphia: W. B. Saunders Company.


==References==
==Case Studies==
{{Reflist|2}}


==External link==
[[Veno-occlusive disease case study one|Case #1]]
* [http://www.asheducationbook.org/cgi/content/full/2004/1/372 American Society of Hematology education book] discussion of VOD


[[Category:Hepatology]]
[[Category:Hepatology]]
[[Category:Hematology]]
[[Category:Hematology]]

Revision as of 15:54, 21 September 2012

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Editor-In-Chief: C. Michael Gibson, M.S., M.D. [1]

Synonyms and Keywords: VOD, sinuosoidal obstruction syndrome

Overview

Historical Perspective

Classification

Pathophysiology

Causes

Differentiating Veno-occlusive disease from other Diseases

Epidemiology and Demographics

Risk Factors

Screening

Natural History, Complications and Prognosis

Diagnosis

History and Symptoms | Physical Examination | Laboratory Findings | Biomarker Panel | Chest X Ray | HLA Analysis | Skin Punch Biopsy | Ultrasound | Other Imaging Findings | Other Diagnostic Studies

Treatment

Medical Therapy | Surgery | Primary Prevention | Secondary Prevention | Cost-Effectiveness of Therapy | Future or Investigational Therapies

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Case #1