Peliosis hepatis presenting with massive hepatomegaly in a patient with idiopathic thrombocytopenic purpura

Clin Mol Hepatol. 2015 Dec;21(4):387-92. doi: 10.3350/cmh.2015.21.4.387. Epub 2015 Dec 24.

Abstract

Peliosis hepatis is a rare condition that can cause hepatic hemorrhage, rupture, and ultimately liver failure. Several authors have reported that peliosis hepatis develops in association with chronic wasting disease or prolonged use of anabolic steroids or oral contraceptives. In this report we describe a case in which discontinuation of steroid therapy improved the condition of a patient with peliosis hepatis. Our patient was a 64-year-old woman with a history of long-term steroid treatment for idiopathic thrombocytopenic purpura . Her symptoms included abdominal pain and weight loss; the only finding of a physical examination was hepatomegaly. We performed computed tomography (CT) and magnetic resonance imaging (MRI) of the liver and a liver biopsy. Based on these findings plus clinical observations, she was diagnosed with peliosis hepatis and her steroid treatment was terminated. The patient recovered completely 3 months after steroid discontinuation, and remained stable over the following 6 months.

Keywords: Hepatomegaly; Peliosis hepatis; Steroids.

Publication types

  • Case Reports

MeSH terms

  • Adrenal Cortex Hormones / therapeutic use
  • Female
  • Hepatomegaly / complications
  • Hepatomegaly / diagnosis*
  • Hepatomegaly / pathology
  • Humans
  • Liver / pathology
  • Magnetic Resonance Imaging
  • Middle Aged
  • Peliosis Hepatis / complications
  • Peliosis Hepatis / diagnosis*
  • Peliosis Hepatis / pathology
  • Purpura, Thrombocytopenic, Idiopathic / complications
  • Purpura, Thrombocytopenic, Idiopathic / diagnosis*
  • Purpura, Thrombocytopenic, Idiopathic / drug therapy
  • Tomography, X-Ray Computed
  • Treatment Outcome

Substances

  • Adrenal Cortex Hormones