A case of non-cirrhotic portal hypertension with occluded centrtal veins which was caused by pyrrolizidine alkaloid in an herb tea

Abstract

A 37-year old woman was admitted to our hospital because of ascites and leg edema. She was administered "Takugo" an herb tea, which included pyrrolizidine alkaloid, for about ten years. Liver function test and the findings of angiography and hepatic venography were demonstrated nearly normal, but she had portal hypertension (the dilatations of portal vein and umbilical vein, gastroesophageal varices). The finding of peritoneoscopy was demonstrated "large white liver". A needle biopsy specimen of the liver showed the findings of occluded central veins. She had already administered the sum of 2g of pyrrolizidine alkaloid. So, we concluded it may be non-cirrhotic portal hypertension with occluded central veins, so called veno-occlusive disease of the liver, which was caused by pyrrolizidine alkaloid in an herb tea.