Article
Hepatoportal sclerosis related to the use of herbals and nutritional supplements. Causality or coincidence?
Registro en:
RIOS, F. F. et al. Hepatoportal sclerosis related to the use of herbals and nutritional supplements. Causality or coincidence? Annals of Hepatology, v. 15, n. 6, p. 932-938, 2016.
1665-2681
10.5604/16652681.1222113
Autor
Rios, Fernanda Ferreira
Freitas, Luiz Antonio Rodrigues de
Codes, Liana
Santos Junior, Genario Oliveira
Schinoni, Maria Isabel
Paraná, Raymundo
Resumen
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.