Peliosis hepatis natural history, complications and prognosis: Difference between revisions

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==Overview==
==Overview==
If left untreated, some patients with Peliosis Hepatis may progress to develop hemoperitoneum.


==Natural History==
==Natural History==


==Complications==
==Complications==
*'''Infections:''' [[HIV]], Bacillary peliosis (caused by genus  ''[[Bartonella]]'', bacteria responsible for [[cat-scratch disease]] which are identified histologically adjacent to the peliotic lesions.<ref name="pmid9407154">{{cite journal| author=Koehler JE, Sanchez MA, Garrido CS, Whitfeld MJ, Chen FM, Berger TG | display-authors=etal| title=Molecular epidemiology of bartonella infections in patients with bacillary angiomatosis-peliosis. | journal=N Engl J Med | year= 1997 | volume= 337 | issue= 26 | pages= 1876-83 | pmid=9407154 | doi=10.1056/NEJM199712253372603 | pmc= | url=https://www.ncbi.nlm.nih.gov/entrez/eutils/elink.fcgi?dbfrom=pubmed&tool=sumsearch.org/cite&retmode=ref&cmd=prlinks&id=9407154  }} </ref>
If left untreated, some patients with Peliosis Hepatis may progress to develop hemoperitoneum. <ref name="pmid32595044">{{cite journal| author=| title=Correction to Lancet Infectious Diseases 2020; published online April 29. https://doi.org/10.1016/ S1473-3099(20)30064-5. | journal=Lancet Infect Dis | year= 2020 | volume= 20 | issue= 7 | pages= e148 | pmid=32595044 | doi=10.1016/S1473-3099(20)30370-4 | pmc= | url=https://www.ncbi.nlm.nih.gov/entrez/eutils/elink.fcgi?dbfrom=pubmed&tool=sumsearch.org/cite&retmode=ref&cmd=prlinks&id=32595044 }} </ref>
 
*'''Chronic conditions:'''  End stage [[renal failure]], [[Kwashiorkor]], [[tuberculosis]] and other chronic infections.
*'''Malignancy:''' [[Monoclonal gammopathy|Monoclonal gammopathies]] ([[multiple myeloma]] and [[Waldenstrom macroglobulinemia]]), [[Hodgkin's disease]], [[malignant histiocytosis]], [[seminoma]], [[hepatocellular adenoma]] and [[Hepatocellular carcinoma|hepatocarcinoma]],<ref>{{cite journal |author=Haboubi NY, Ali HH, Whitwell HL, Ackrill P |title=Role of endothelial cell injury in the spectrum of azathioprine-induced liver disease after renal transplant: light microscopy and ultrastructural observations |journal=Am. J. Gastroenterol. |volume=83 |issue=3 |pages=256-61 |year=1988 |pmid=3278593}}</ref>
*'''Renal transplants:'''  It can be found in up to 20% patients, can be related to azathioprine or cyclosporine use and may be associated with increased risk of [[transplant rejection]]<ref>{{cite journal |author=Izumi S, Nishiuchi M, Kameda Y, Nagano S, Fukunishi T, Kohro T, Shinji Y |title=Laparoscopic study of peliosis hepatis and nodular transformation of the liver before and after renal transplantation: natural history and aetiology in follow-up cases |journal=J. Hepatol. |volume=20 |issue=1 |pages=129-37 |year=1994 |pmid=8201214}}</ref><ref>{{cite journal |author=Cavalcanti R, Pol S, Carnot F, Campos H, Degott C, Driss F, Legendre C, Kreis H |title=Impact and evolution of peliosis hepatis in renal transplant recipients |journal=Transplantation |volume=58 |issue=3 |pages=315-6 |year=1994 |pmid=8053054}}</ref>.
*'''Drugs and toxins:''' [[Corticosteroids]], [[androgens]], [[methyltestosterone]], [[azathioprine]], [[tamoxifen]]<ref>{{cite book | last = Goldman | first = Lee | title = Cecil Textbook of Medicine -- 2-Volume Set, Text with Continually Updated Online Reference | publisher = W.B. Saunders Company | location = Philadelphia | year = 2003 | isbn = 0721645631 }}</ref>
 
===Prognosis===
Depending on if the right diagnosis was made, the prognosis may vary. Peliosis hepatis should not be drained. If mistaken for [[hepatic abscess]] and drained, it can lead to life-threatening [[hemorrhage]]. However, the prognosis is generally regarded as excellent.<ref name="pmid7949724">{{cite journal| author=Cohen GS, Ball DS, Boyd-Kranis R, Gembala RB, Wurzel J| title=Peliosis hepatis mimicking hepatic abscess: fatal outcome following percutaneous drainage. | journal=J Vasc Interv Radiol | year= 1994 | volume= 5 | issue= 4 | pages= 643-5 | pmid=7949724 | doi=10.1016/s1051-0443(94)71572-4 | pmc= | url=https://www.ncbi.nlm.nih.gov/entrez/eutils/elink.fcgi?dbfrom=pubmed&tool=sumsearch.org/cite&retmode=ref&cmd=prlinks&id=7949724 }} </ref>


==Prognosis==
==Prognosis==
Prognosis is uncertain, and most patients will remain asymptomatic. In some individuals, it can lead to a life-threatening complication with a high rate of mortality. <ref name="pmid19916182">{{cite journal| author=Choi SK, Jin JS, Cho SG, Choi SJ, Kim CS, Choe YM | display-authors=etal| title=Spontaneous liver rupture in a patient with peliosis hepatis: a case report. | journal=World J Gastroenterol | year= 2009 | volume= 15 | issue= 43 | pages= 5493-7 | pmid=19916182 | doi=10.3748/wjg.15.5493 | pmc=2778108 | url=https://www.ncbi.nlm.nih.gov/entrez/eutils/elink.fcgi?dbfrom=pubmed&tool=sumsearch.org/cite&retmode=ref&cmd=prlinks&id=19916182  }} </ref>


==References==
==References==

Latest revision as of 02:16, 19 January 2021

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Overview

If left untreated, some patients with Peliosis Hepatis may progress to develop hemoperitoneum.

Natural History

Complications

If left untreated, some patients with Peliosis Hepatis may progress to develop hemoperitoneum. [1]

Prognosis

Prognosis is uncertain, and most patients will remain asymptomatic. In some individuals, it can lead to a life-threatening complication with a high rate of mortality. [2]

References

  1. ↑ "Correction to Lancet Infectious Diseases 2020; published online April 29. https://doi.org/10.1016/ S1473-3099(20)30064-5". Lancet Infect Dis. 20 (7): e148. 2020. doi:10.1016/S1473-3099(20)30370-4. PMID 32595044 Check |pmid= value (help). External link in |title= (help)
  2. ↑ Choi SK, Jin JS, Cho SG, Choi SJ, Kim CS, Choe YM; et al. (2009). "Spontaneous liver rupture in a patient with peliosis hepatis: a case report". World J Gastroenterol. 15 (43): 5493–7. doi:10.3748/wjg.15.5493. PMC 2778108. PMID 19916182.

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