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Concept
Peliosis hepatis
Résumé
Peliosis hepatis is an uncommon vascular condition characterised by multiple, randomly distributed, blood-filled cavities throughout the liver. The size of the cavities usually ranges between a few millimetres and 3 cm in diameter. In the past, it was a mere histological curiosity occasionally found at autopsies, but has been increasingly recognised with wide-ranging conditions from AIDS to the use of anabolic steroids. It also occasionally affects spleen, lymph nodes, lungs, kidneys, adrenal glands, bone marrow, and other parts of gastrointestinal tract.
Peliosis hepatis is often erroneously written "peliosis hepatitis", despite its not being one of the hepatitides. The correct term arises from the Greek pelios, i.e. discoloured by extravasated blood, livid, and the Latinized genitive case (hepatis) of the Greek hepar, liver.
Often, peliosis hepatis causes no symptoms (asymptomatic). In other cases, it may be identified after blood tests show abnormalities in liver enzymes.
Less commonly, peliosis hepatis may cause abdominal pain, especially right upper quadrant pain, or jaundice.
Infections: HIV, bacillary peliosis (caused by genus Bartonella, bacteria responsible for cat-scratch disease which are identified histologically adjacent to the peliotic lesions), Staphylococcus aureus
Chronic conditions: End stage kidney failure, kwashiorkor, tuberculosis, and other chronic infections
Malignancy: Monoclonal gammopathies (multiple myeloma and Waldenström's macroglobulinemia), Hodgkin disease, malignant histiocytosis, seminoma, hepatocellular adenoma, and hepatocarcinoma
Kidney 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.
Drugs and toxins: Corticosteroids, androgens, azathioprine, tamoxifen
The pathogenesis of peliosis hepatis is unknown. Several hypotheses are given, such as it arises from sinusoidal epithelial damage, increased sinusoidal pressure due to obstruction in blood outflow from the liver, or hepatocellular necrosis.
Source officielle
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