Gene/Protein Disease Symptom Drug Enzyme Compound
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Query: UMLS:C0023890 (cirrhosis)
 42,195 document(s) hit in 31,850,051 MEDLINE articles (0.00 seconds)

Peliosis hepatis and hepatic sinusoidal dilatations are rare vascular liver diseases that occur at increased frequency in kidney transplant recipients. We retrospectively evaluated in kidney transplant recipients the natural history of vascular liver diseases, their impact on patient and graft survival, and the influence of AZA withdrawal. Between 1970 and 1990, vascular liver disease was diagnosed in 32 cadaver kidney transplant recipients 1-128 months after transplantation (mean 41 months). Diagnosis was based on histology in all cases. Patients received conventional immunosuppression (high dose steroids and AZA). Twenty patients had a minor form (sinusoidal dilatations or focal peliosis), while 12 had a major form (diffuse peliosis) of vascular hepatic disease. Two patients were lost to follow-up and 1 died at the time of diagnosis. In 12 patients (group 1), AZA dosage remained unchanged, while it was interrupted at the time of diagnosis in 17 patients (group 2). Five group 1 patients underwent serial liver biopsies, which showed persistence of vascular hepatic disease in 3 (with regenerative nodular hyperplasia in 1) and disappearance in 2 patients. Eight group 2 patients underwent serial liver biopsies, which showed disappearance of vascular hepatic disease in 6 patients and persistence in 2. Moreover, regenerative nodular hyperplasia was noted in 1 case, perisinusoidal fibrosis in 1 case, and cirrhosis in 6 cases. Three patients of group 1 and 11 patients of group 2 returned to dialysis a mean of 21 and 39 months after diagnosis, respectively. Eight patients died and death was clearly associated with major peliosis in 2 cases. In kidney transplant recipients, vascular hepatic disease may be associated with high mortality, especially in major forms. Our findings indicate that peliosis hepatis may lead to severe fibrosing liver lesions. The course of vascular hepatic disease is not clearly modified by AZA withdrawal.
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PMID:Impact and evolution of peliosis hepatis in renal transplant recipients. 805 54

Peliosis hepatis is an uncommon entity characterized by multiple oval and irregularly shaped blood-filled cystic cavities in the liver parenchyma. The spaces are lined by either hepatocytes or endothelial cells. They communicate with the sinusoids, many of which are dilated. The condition has been associated with cirrhosis, malignancy, infection with tuberculosis and HIV, and medication such as anabolic or androgenic steroids. The etiology is uncertain, but toxic injury to the sinusoidal wall is postulated. The condition may present with hepatomegaly, cirrhosis and portal hypertension, hepatic failure, or shock from hepatic or splenic rupture. The authors report the case of a patient who developed peliosis hepatis while taking oral contraceptives. Abdominal ultrasound performed upon the 35-year-old woman presenting with right upper quadrant abdominal pain identified multiple, well-circumscribed liver lesions of varying size and echogenicity. No blood flow was detected on color duplex ultrasound and the rest of the abdominal examination was normal. Her condition was attributed to oral contraceptive use. Such use was therefore discontinued, and 6 months later the lesions were found to have reduced in size. The patient's pain had reduced considerably and she was clinically well. Follow-up is mandatory in such cases following diagnosis and treatment.
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PMID:Peliosis hepatis associated with oral contraceptive use. 868 55