title: Peliosis hepatis presenting with massive hepatomegaly in a patient with idiopathic thrombocytopenic purpura.
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.
authors.affiliation: Department of Internal Medicine, Yonsei University College of Medicine, Seoul, Korea.
authors.forename: Sun Bean
authors.initials: SB
authors.lastname: Kim
authors.affiliation: Department of Pathology, Yonsei University College of Medicine, Seoul, Korea.
authors.forename: Do Kyung
authors.initials: DK
authors.lastname: Kim
authors.affiliation: Department of Internal Medicine, Yonsei University College of Medicine, Seoul, Korea.
authors.forename: Sun Jeong
authors.initials: SJ
authors.lastname: Byun
authors.affiliation: Department of Pathology, Yonsei University College of Medicine, Seoul, Korea.
authors.forename: Ji Hye
authors.initials: JH
authors.lastname: Park
authors.affiliation: Department of Radiology, Yonsei University College of Medicine, Seoul, Korea.
authors.forename: Jin Young
authors.initials: JY
authors.lastname: Choi
authors.affiliation: Department of Pathology, Yonsei University College of Medicine, Seoul, Korea.; Liver Cancer Special Clinic, Yonsei University College of Medicine, Seoul, Korea.
authors.forename: Young Nyun
authors.initials: YN
authors.lastname: Park
authors.affiliation: Department of Internal Medicine, Yonsei University College of Medicine, Seoul, Korea.; Liver Cancer Special Clinic, Yonsei University College of Medicine, Seoul, Korea.
authors.forename: Do Young
authors.initials: DY
authors.lastname: Kim
mesh_terms: D000305:Adrenal Cortex Hormones / Q000627:therapeutic use; D005260:Female; D006529:Hepatomegaly / Q000150:complications / Q000175:diagnosis* / Q000473:pathology; D006801:Humans; D008099:Liver / Q000473:pathology; D008279:Magnetic Resonance Imaging; D008875:Middle Aged; D010382:Peliosis Hepatis / Q000150:complications / Q000175:diagnosis* / Q000473:pathology; D016553:Purpura, Thrombocytopenic, Idiopathic / Q000150:complications / Q000175:diagnosis* / Q000188:drug therapy; D014057:Tomography, X-Ray Computed; D016896:Treatment Outcome
chemical_list: D000305:Adrenal Cortex Hormones
keywords: Hepatomegaly; Peliosis hepatis; Steroids