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Drugs and Toxins Affecting Liver Vessels

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Vascular Disorders of the Liver

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Abstract

Vascular liver injury has been reported for more than 1300 conventional medications, herbal teas, as well as recreative agents. Drugs have thus been associated with a wide spectrum of vascular liver diseases, including thromboses of the large veins (i.e Budd-Chiari syndrome and portal vein thrombosis) as well as microvascular injury - including porto-sinusoidal vascular disease (PSVD) - and sinusoidal lesions, including sinusoidal obstruction syndrome (SOS) also named veno-occlusive disease, peliosis, and isolated sinusoidal distension. Toxic injury to liver vessels is mainly related to metabolite-mediated endothelial injury. The most frequently reported drugs associated with vascular liver injury are as follows, in decreasing order of frequency: (i) hormones, (ii) thiopurine derivatives, (iii) didanosine, (iv) oxaliplatin, and (vi) medicinal agents and toxins (i.e. pyrrolizidine alcaloids, vitamin A, and vinyl chloride monomer). There is a strong level of imputability for oxaliplatin and pyrrolizidine alcaloids-related liver injury. By contrast, the data for a direct relationship between oral contraceptives, didanosine, and thiopurin derivatives and vascular liver lesions are still not fully conclusive.

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Abbreviations

DILI:

drug induced liver injury

HIV:

human immunodeficiency virus

NRH:

nodular regenerative hyperplasia

SOS:

sinusoidal obstruction syndrome

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Authors and Affiliations

  1. Services de Transplantation et Hépato-gastroentérologie, Hôpitaux Universitaires de Genève, Geneva, Switzerland

    Laure Elkrief

  2. Service d’hépato-gastroentérologie, Hôpital Trousseau, CHRU de Tours, Chambray-lès-Tours, France

    Laure Elkrief

  3. Service de Pathologie clinique, Hôpitaux Universitaires et Faculté de Médecine de Genève, Geneva, Switzerland

    Laura Rubbia-Brandt

Authors
  1. Laure Elkrief
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  2. Laura Rubbia-Brandt
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Correspondence to Laura Rubbia-Brandt .

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Editors and Affiliations

  1. CRI, UMR 1149, Université de Paris and Inserm, Paris, France

    Dominique Valla

  2. Hospital Clinic, Hepatic Hemodynamic Lab Hospital Clinic, Barcelona, Spain

    Juan Carlos Garcia-Pagan

  3. Gastroenterology and Hepatology, Ente Ospedaliero Cantonale, Lugano, Switzerland

    Andrea De Gottardi

  4. Université de Paris, Paris, France

    Pierre-Emmanuel Rautou

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Elkrief, L., Rubbia-Brandt, L. (2022). Drugs and Toxins Affecting Liver Vessels. In: Valla, D., Garcia-Pagan, J.C., De Gottardi, A., Rautou, PE. (eds) Vascular Disorders of the Liver . Springer, Cham. https://doi.org/10.1007/978-3-030-82988-9_21

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  • DOI: https://doi.org/10.1007/978-3-030-82988-9_21

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