Peliosis hepatis natural history, complications and prognosis
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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
Natural History
Complications
- Infections: HIV, Bacillary peliosis (caused by genus Bartonella, bacteria responsible for cat-scratch disease which are identified histologically adjacent to the peliotic lesions.[1]
- Chronic conditions: End stage renal failure, Kwashiorkor, tuberculosis and other chronic infections.
- Malignancy: Monoclonal gammopathies (multiple myeloma and Waldenstrom macroglobulinemia), Hodgkin's disease, malignant histiocytosis, seminoma, hepatocellular adenoma and hepatocarcinoma,[2]
- 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[3][4].
- Drugs and toxins: Corticosteroids, androgens, methyltestosterone, azathioprine, tamoxifen[5]
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.[6]
Prognosis
References
- ↑ Koehler JE, Sanchez MA, Garrido CS, Whitfeld MJ, Chen FM, Berger TG; et al. (1997). "Molecular epidemiology of bartonella infections in patients with bacillary angiomatosis-peliosis". N Engl J Med. 337 (26): 1876–83. doi:10.1056/NEJM199712253372603. PMID 9407154.
- ↑ Haboubi NY, Ali HH, Whitwell HL, Ackrill P (1988). "Role of endothelial cell injury in the spectrum of azathioprine-induced liver disease after renal transplant: light microscopy and ultrastructural observations". Am. J. Gastroenterol. 83 (3): 256–61. PMID 3278593.
- ↑ Izumi S, Nishiuchi M, Kameda Y, Nagano S, Fukunishi T, Kohro T, Shinji Y (1994). "Laparoscopic study of peliosis hepatis and nodular transformation of the liver before and after renal transplantation: natural history and aetiology in follow-up cases". J. Hepatol. 20 (1): 129–37. PMID 8201214.
- ↑ Cavalcanti R, Pol S, Carnot F, Campos H, Degott C, Driss F, Legendre C, Kreis H (1994). "Impact and evolution of peliosis hepatis in renal transplant recipients". Transplantation. 58 (3): 315–6. PMID 8053054.
- ↑ Goldman, Lee (2003). Cecil Textbook of Medicine -- 2-Volume Set, Text with Continually Updated Online Reference. Philadelphia: W.B. Saunders Company. ISBN 0721645631.
- ↑ Cohen GS, Ball DS, Boyd-Kranis R, Gembala RB, Wurzel J (1994). "Peliosis hepatis mimicking hepatic abscess: fatal outcome following percutaneous drainage". J Vasc Interv Radiol. 5 (4): 643–5. doi:10.1016/s1051-0443(94)71572-4. PMID 7949724.