Hirmi Valley liver disease: A disease associated with exposure to pyrrolizidine alkaloids and DDT

Robinson, Oliver; Want, Elizabeth J.; Coen, Muireann; Kennedy, Ruth; Bosch, C; Gebrehawaria, Yohannes; Kudo, Hiromi; Sadiq, Fouzia; Goldin, Robert; Hauser, Michael; Fenwick, Alan; Toledano, Mireille B.; Thursz, Mark

doi:10.1016/j.jhep.2013.07.039

Cited by 42 publications

(50 citation statements)

References 10 publications

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“…VOD/SOS is most often associated with the chemotherapy used in preparing patients for stem cell transplantation and is a significant complication in patients taking gemtuzumab . Pyrrolizidine alkaloids, a natural product long associated with VOD/SOS, may contaminate stored grain, leading to epidemics of hepatic injury …”

Section: Defining the Pattern Of Injurymentioning

confidence: 99%

Histopathological challenges in suspected drug‐induced liver injury

Kleiner

2017

Liver International

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When a patient with suspected drug-induced liver injury (DILI) undergoes liver biopsy, the pathologist is confronted with two major challenges. The first and most important is to establish the pattern(s) of injury which are present. Patterns of injury represent stereotypical responses of an organ to injury and relate to specific aetiologies of liver damage. The pattern of injury and the histological details of that injury can then be analysed with respect to the patient's intercurrent diseases and medication history.The specific expertise of the pathologist can be used to weigh the prospect of DILI against the likelihood of other explanations of injury. The second challenge is to characterize specific types of injury and the severity of injury, both of which may have importance for clinical decision-making and prognosis. The pathologist's report should convey both an accurate description of the pathology as well its interpretation. K E Y W O R D Sacute hepatitis, autoimmune hepatitis, cholestasis, hepatic necrosis, hepatotoxicity

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Section: Defining the Pattern Of Injurymentioning

confidence: 99%

Histopathological challenges in suspected drug‐induced liver injury

Kleiner

2017

Liver International

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“…100 Comfrey-induced injury involves fibrous obliteration and destruction of hepatic veins, leading to cirrhosis. 101,102 However, hepatotoxicity, including SOS, acute or chronic hepatitis, cholestasis, hepatic necrosis or fibrosis, cirrhosis, and outright liver failure, can occur with a much broader array of herbal products, 103 owing to variability in what plant components have been used, storage conditions for the plant products, mislabeling or misidentification of the plant, and outright contaminations, 104,105 Even Echinacea, widely touted as being completely free of toxicities, is known to contain pyrrolizidine alkaloids and may induce hepatotoxicity. 106 Clinical presentation of hepatotoxicity arising in the setting of herbal product use is non-specific, involving fatigue, loss of appetite, and potentially jaundice.…”

Section: Exposure To Herbal Toxinsmentioning

confidence: 99%

Sinusoidal Obstruction Syndrome (Hepatic Veno-Occlusive Disease)

Fan

Crawford

2014

Journal of Clinical and Experimental Hepatology

228

178

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“…Secondly, the effects of certain agents may be altered when co-exposed to other time-varying agents through synergistic or interactive effects. For instance, exposure to the widely distributed pollutant, dichlorodiphenyltrichloroethane (DDT) alters expression of hepatic metabolic enzymes, thereby enhancing susceptibility to other environmental toxicants [14]. The improved understanding of the combined health effects of exposure mixtures generally encountered in reality is one of the promises of the exposome.…”

Section: The Dynamic Exposomementioning

confidence: 99%

The Pregnancy Exposome

Robinson

Vrijheid

2015

Curr Envir Health Rpt

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The exposome concept takes a holistic approach facilitated by new and emerging technologies to describe 'the totality of human environmental (i.e. non-genetic) exposures from conception onwards, complementing the genome'. It provides a framework to advance the environmental epidemiology field that has until now focused almost exclusively on single-exposure health effects. The exposome includes an external domain, measured by methods including geo-spatial modelling, questionnaire and biomonitoring of external exposures while the internal domain is commonly assessed through molecular omics platforms. The internal domain, in part, reflects the biological response to the external domain. New statistical frameworks are required to integrate and assess exposome-health effects. The pregnancy period is a key starting point to describe the dynamic exposome, due to its heightened sensitivity and potential lifetime impact. A handful of studies have started to move towards an exposome approach in assessing the effects of the multiple exposures during pregnancy on child development. New research projects are underway to test the exposome approach on a large scale.

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Hirmi Valley liver disease: A disease associated with exposure to pyrrolizidine alkaloids and DDT

Abstract: This novel form of disease appears to be caused by co-exposure to acetyllycopsamine and DDT.

Cited by 42 publications

References 10 publications

Histopathological challenges in suspected drug‐induced liver injury

Histopathological challenges in suspected drug‐induced liver injury

Sinusoidal Obstruction Syndrome (Hepatic Veno-Occlusive Disease)

The Pregnancy Exposome

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