title: Peliosis of the spleen with massive recurrent haemorrhagic ascites, despite splenectomy, and associated with elevated levels of vascular endothelial growth factor.
abstract: We present the case of a 33-year-old man with isolated splenic peliosis, a rare pathological condition characterized by blood filled cystic lesions. The patient presented with recurrent massive haemorrhagic ascites, which did not resolve, despite a splenectomy. He was found to have massively elevated levels of vascular endothelial growth factor (VEGF). The clinical course of the disease was prolonged. Repeated blood transfusions for recurrent anaemia were required, in addition to repeated aspiration of reaccumulating haemorrhagic ascites and pleural effusion. The clinical course was not in keeping with previously reported cases. We have described an atypical clinical presentation in a patient with isolated splenic peliosis associated with elevated VEGF concentrations. No previously known associations for the condition were found despite thorough investigations. Management of the patient has been symptomatic and palliative. We have reviewed the various reported associations of peliosis and discussed the possible role of VEGF in this patient's condition.
authors.affiliation: Department of Medicine, Arrowe Park Hospital, Wirral, Merseyside, UK. drfrankjoseph@yahoo.co.uk
authors.forename: Franklin
authors.initials: F
authors.lastname: Joseph
authors.forename: Navid
authors.initials: N
authors.lastname: Younis
authors.forename: Geoffery
authors.initials: G
authors.lastname: Haydon
authors.forename: David H
authors.initials: DH
authors.lastname: Adams
authors.forename: Siann
authors.initials: S
authors.lastname: Wynne
authors.forename: Martin B
authors.initials: MB
authors.lastname: Gillet
authors.forename: Yasmine M
authors.initials: YM
authors.lastname: Maurice
authors.forename: Mark E
authors.initials: ME
authors.lastname: Lipton
authors.forename: David
authors.initials: D
authors.lastname: Berstock
authors.forename: Ian R
authors.initials: IR
authors.lastname: Jones
mesh_terms: D000328:Adult; D001201:Ascites / Q000150:complications* / Q000473:pathology / Q000601:surgery; D003560:Cysts / Q000150:complications* / Q000473:pathology / Q000601:surgery; D006470:Hemorrhage / Q000150:complications* / Q000473:pathology / Q000601:surgery; D006801:Humans; D008297:Male; D010996:Pleural Effusion / Q000150:complications / Q000473:pathology / Q000601:surgery; D012008:Recurrence; D013154:Spleen / Q000473:pathology; D013156:Splenectomy / Q000379:methods*; D013158:Splenic Diseases / Q000150:complications* / Q000473:pathology / Q000601:surgery; D016896:Treatment Outcome; D042461:Vascular Endothelial Growth Factor A / Q000097:blood*
chemical_list: D042461:Vascular Endothelial Growth Factor A