{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,3,12]],"date-time":"2026-03-12T07:28:47Z","timestamp":1773300527352,"version":"3.50.1"},"reference-count":43,"publisher":"Wiley","issue":"1","license":[{"start":{"date-parts":[[2011,12,21]],"date-time":"2011-12-21T00:00:00Z","timestamp":1324425600000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/onlinelibrary.wiley.com\/termsAndConditions#vor"}],"content-domain":{"domain":["onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["J of Digest Diseases"],"published-print":{"date-parts":[[2012,1]]},"abstract":"<jats:p><jats:bold>OBJECTIVE:\u2003<\/jats:bold> Hepatic sinusoidal obstruction syndrome (HSOS) induced by a Chinese medicinal herb <jats:italic>Tusanqi<\/jats:italic> is increasingly being reported in recent years. The aim of the study was to investigate the possibility of using blood pyrrole\u2010protein adducts test as a confirmatory diagnostic method.<\/jats:p><jats:p><jats:bold>METHODS:\u2003<\/jats:bold> Patients with HSOS according to international diagnostic criteria associated with <jats:italic>Tusanqi<\/jats:italic> from January 2006 to August 2010 in Zhongshan Hospital Fudan University were included and clinical features were collected. Pyrrole\u2010protein adducts in blood sample were determined with ultra performance liquid chromatography\u2010mass spectrometry (UPLC\u2010MS) while pyrrolizidine alkaloids (PAs) in available herbal preparations were analyzed by high performance liquid chromatography\u2010ultraviolet (HPLC\u2010UV).<\/jats:p><jats:p><jats:bold>RESULTS:\u2003<\/jats:bold> Five patients (age 41\u201372 years, median age 54 years, all women) were included. Ascites (5\/5), jaundice (5\/5) and hepatomegaly (4\/5) were common manifestations. The imaging features were diffused, patchy hepatic enhancement, periportal edema and ascites. Pathology ascertained that blood flow was obstructive at the site of sinusoid. PAs (<jats:italic>Seneionine<\/jats:italic> and seneciphylline) were identified in all the three available herbal preparations ingested by the HSOS patients. Pyrrole\u2010protein adducts were unequivocally found in all the five blood samples. Two patients recovered, two developed chronic illness and one died due to liver failure and hepatic encephalopathy.<\/jats:p><jats:p><jats:bold>CONCLUSIONS:\u2003<\/jats:bold> The detection of blood pyrrole\u2010protein adducts using a UPLC\u2010MS approach is a specific, reliable, unambiguous and confirmatory test for HSOS induced by PA, and should be used together with the conventional HSOS clinical diagnostic criteria for the definitive diagnosis of PA\u2010induced HSOS.<\/jats:p>","DOI":"10.1111\/j.1751-2980.2011.00552.x","type":"journal-article","created":{"date-parts":[[2011,10,31]],"date-time":"2011-10-31T17:08:38Z","timestamp":1320080918000},"page":"33-39","update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":92,"title":["Definitive diagnosis of hepatic sinusoidal obstruction syndrome induced by pyrrolizidine 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