Please use this identifier to cite or link to this item:
https://www.arca.fiocruz.br/handle/icict/17926
HEPATOPORTAL SCLEROSIS RELATED TO THE USE OF HERBALS AND NUTRITIONAL SUPPLEMENTS. CAUSALITY OR COINCIDENCE?
Esclerose hepatoportal
Venopatia portal obliterante
Fígado.
Hepatotoxicidade Herbalife
Hepatoportal sclerosis
Obliterative portal venopathy
Liver
Herbalife hepatotoxicity
Author
Affilliation
Federal University of Bahia. School of Medical Sciences. Salvador, BA, Brazil
Federal University of Bahia. School of Medical Sciences. Salvador, BA, Brazil / Fundação Oswaldo Cruz. Centro de Pesquisas Gonçalo Moniz. LPBI. Department of Pathology. Salvador, BA, Brasil
Federal University of Bahia. Prof. Edgard Santos University Hospital. Salvador, BA, Brasil
Federal University of Bahia. Prof. Edgard Santos University Hospital. Salvador, BA, Brasil
Federal University of Bahia. School of Medical Sciences. Salvador, BA, Brazil / Federal University of Bahia. Institute of Science and Health. Salvador, BA, Brasil
Federal University of Bahia. School of Medical Sciences. Salvador, BA, Brazil / Federal University of Bahia. Prof. Edgard Santos University Hospital. Salvador, BA, Brasil
Federal University of Bahia. School of Medical Sciences. Salvador, BA, Brazil / Fundação Oswaldo Cruz. Centro de Pesquisas Gonçalo Moniz. LPBI. Department of Pathology. Salvador, BA, Brasil
Federal University of Bahia. Prof. Edgard Santos University Hospital. Salvador, BA, Brasil
Federal University of Bahia. Prof. Edgard Santos University Hospital. Salvador, BA, Brasil
Federal University of Bahia. School of Medical Sciences. Salvador, BA, Brazil / Federal University of Bahia. Institute of Science and Health. Salvador, BA, Brasil
Federal University of Bahia. School of Medical Sciences. Salvador, BA, Brazil / Federal University of Bahia. Prof. Edgard Santos University Hospital. Salvador, BA, Brasil
Abstract
Introduction and aim. Non-cirrhotic idiopathic portal hypertension (NCIPH), also known as hepatoportal sclerosis (HPS) is a disease of uncertain etiology. However, various pathophysiological mechanisms has been postulated, including chronic or recurrent infections and exposure to drugs or toxins. In this context, it appears to be of multifactorial etiology or resulting from a portal vascular endothelium aggression. It is important to consider whether the use of dietary supplements and herbs can trigger or contribute to the occurance of HPS. We report a possible association of HPS with the consumption of herbals and / or dietary supplements.Material and methods. We describe two cases of HPS in patients without known etiology causes associated with
this disease. Results. Both patients were females who were diagnosed with HPS following the consumption of Herbalife® products
and putative anorexigenic agents in the herbal infusions. Image-based analysis and the assessment of the histopathological alterations
found in the livers confirmed the diagnosis. The histopatological analysis of liver samples from both patients showed portal
tracts enlarged by fibrosis with disappearance or reduction in the diameter of the portal vein branches. In many portal tracts, portal veins
branches were replaced by aberrant thin-walled fendiforme vessels. The bile ducts and branches of the hepatic artery show normal aspects.
Conclusion. After the exclusion of other etiologic factors and a comprehensive analysis of clinical history, consumption of
Herbalife® products and anorexigenic agents was pointed-out as a puttative predisposing factor for the development of the disease.
Keywords in Portuguese
Fibrose portal não cirróticaEsclerose hepatoportal
Venopatia portal obliterante
Fígado.
Hepatotoxicidade Herbalife
Keywords
Non-cirrhotic portal fibrosisHepatoportal sclerosis
Obliterative portal venopathy
Liver
Herbalife hepatotoxicity
Share