Published online Mar 7, 2014. doi: 10.3748/wjg.v20.i9.2420
Revised: November 27, 2013
Accepted: January 2, 2014
Published online: March 7, 2014
Processing time: 178 Days and 14.7 Hours
Peliosis hepatis (PH) is a vascular lesion of the liver that mimics a hepatic tumor. PH is often associated with underlying conditions, such as chronic infection and tumor malignancies, or with the use of anabolic steroids, immunosuppressive drugs, and oral contraceptives. Most patients with PH are asymptomatic, but some present with abdominal distension and pain. In some cases, PH may induce intraperitoneal hemorrhage and portal hypertension. This study analyzed a 46-year-old male who received a transplanted kidney nine years prior and had undergone long-term immunosuppressive therapy following the renal transplantation. The patient experienced progressive abdominal distention and pain in the six months prior to this study. Initially, imaging studies revealed multiple liver tumor-like abnormalities, which were determined to be PH by pathological analysis. Because the hepatic lesions were progressively enlarged, the patient suffered from complications related to portal hypertension, such as intense ascites and esophageal varices bleeding. Although the patient was scheduled to undergo liver transplantation, he suffered hepatic failure and died prior to availability of a donor organ.
Core tip: Peliosis hepatis (PH) is a vascular lesion of the liver that mimics a hepatic tumor. PH has been associated with the use of anabolic steroids or immunosuppressive drugs. Although most patients remain asymptomatic, some patients suffer from PH-related portal hypertension complications. This case study describes a 46-year-old man who underwent long-term immunosuppressive therapy following renal transplantation. Upon development of abdominal distention, PH was diagnosed by pathological analysis. Ultimately, the patient suffered hepatic failure when the immunosuppressive agent was withdrawn and died.