Sinusoidal obstruction syndrome diagnostic study of choice

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

Diagnostic Criteria

The diagnosis of sinusoidal obstruction syndrome should be considered in any patient who has undergone hematopoietic cell transplant and develops liver dysfunction.

• The two established criteria for the clinical diagnosis of sinusoidal obstruction syndrome are:

Baltimore Criteria	Seattle criteria
Within 30 days of transplantation, bilirubinemia > 34.2 mol/L (2 mg/dL), plus 2 other findings among the following: Hepatomegaly, usually painful  > 5% weight gain Ascites  Ascites	< 200 mg/dl
Blood pH	7.35-7.45
(Na+) – (Cl– + HCO3–)	7 to 13 (mEq/L)
2(Na + K) + (glucose/18) + (blood urea nitrogen/2.8)	285 to 295 mOsm/kg (285 to 295 mmol/kg) of water
Direct measurement	Negative
Direct measurement	Negative
Direct measurement	23 - 29 mEq/L
N/A	BUN: 7-20 mg/dl Creatinine levels: 0.8-1.2mg/dl