Sinusoidal obstruction syndrome medical therapy

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Sinusoidal obstruction syndrome Microchapters

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Overview

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Differentiating Sinusoidal obstruction syndrome from Other Diseases

Epidemiology and Demographics

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Editor-In-Chief: C. Michael Gibson, M.S., M.D. [1]; Associate Editor(s)-in-Chief:

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Overview

Medical Therapy

  • The management of sinusoidal obstruction syndrome depends on the severity of the disease.
  • Supportive care is the mainstay of treatment.
  • Supportive measures include:
    • Maintaining intravascular volume
    • Avoidance of hepatotoxic agents
    • Paracentesis can be done to remove ascitic fluid
    • Narcotics can be used to keep patient pain free.
  • Patients with mild to moderate sinusoidal obstruction syndrome can be treated with supportive care alone. However, severe cases need defibrotide (thrombolytic agent) along with supportive care.{| class="wikitable"

! colspan="1" rowspan="1" align="center" style="background:#4479BA; color: #FFFFFF;" + |Parameters ! colspan="1" rowspan="1" align="center" style="background:#4479BA; color: #FFFFFF;" + |Mild ! colspan="1" rowspan="1" align="center" style="background:#4479BA; color: #FFFFFF;" + |Moderate ! colspan="1" rowspan="1" align="center" style="background:#4479BA; color: #FFFFFF;" + |Severe |- | align="center" style="background:#DCDCDC;" + |Serum total bilirubin |

  • <5 mg/dL

|

  • < (5.1 to 8 mg/dL

|

  • >8 mg/dL

|- | align="center" style="background:#DCDCDC;" + |Serum aspartate aminotransferase (AST) |

  • <3 x normal

|

  • 3 to 8 x normal

|

  • >8 x normal

|- | colspan="1" rowspan="1" align="center" style="background:#DCDCDC;" + |Weight above baseline | colspan="1" rowspan="1" |

  • <2 percent

| colspan="1" rowspan="1" |

  • 2 to 5 percent

|

  • >5 percent

|- | colspan="1" rowspan="1" align="center" style="background:#DCDCDC;" + |Serum creatinine | colspan="1" rowspan="1" |

  • Normal

| colspan="1" rowspan="1" |

  • <2 x normal

|

  • >2 x normal

|}

References

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