We present a case of peliosis hepatis with a typical target-sign enhancement depicted by means of contrast enhanced ultrasound. [ncbi.nlm.nih.gov]

The clinical presentation is quite variable from an asymptomatic presentation to hepatic failure, portal hypertension or fatal intraabdominal hemorrhage. [synapse.koreamed.org]

Hepatomegaly can represent intrinsic liver disease or may be the present- ing physical finding of a generalized disorder. [ospublishers.com]

• Splenomegaly

  We emphasize that, although it is rare, peliosis hepatis should be considered in long-term haemodialysis and renal transplant patients who exhibit hepatomegaly and/or splenomegaly and/or disordered liver function (in particular, elevation of hepatic alkaline [ncbi.nlm.nih.gov]

  Abdominal ultrasound showed a normal liver and splenomegaly. Subsequently, the patient reported being scratched by a cat a few days prior to his transplant, but had no skin abnormalities at presentation. [journals.lww.com]

  Splenomegaly (Patients 1, 3, 4, 5, 6, and 8) and abdominal or retroperitoneal lymphadenopathy (Patients 1, 2, 4, 5, 6, and 8) were also detected clinically or by imaging studies. [doi.org]

• Fever

  Rochalimaea henselae, recently recognized to cause persistent fever and bacteremia in immunocompetent and immunocompromised persons, also causes bacillary angiomatosis and parenchymal bacillary peliosis. [ncbi.nlm.nih.gov]

  Trench fever [ 4, 5 ] Synonyms: shinbone fever, five-day fever, Wolhynia fever, quintana fever, His-Werner disease Epidemiology It is caused by B. quintana. Urban trench fever is now seen in alcoholics and the homeless. [patient.info]

  In recent years, bartonellosis has also been recognized as a group of emerging zoonotic infectious diseases comprised of at least a dozen species of the genus Bartonella, which can cause cat-scratch fever, trench fever, bacillary angiomatosis, and peliosis [medical-dictionary.thefreedictionary.com]

• Sepsis

  The spleen was spared the patient died of sepsis and the postmortem examination confirmed the diagnosis of peliosis hepatis. [ncbi.nlm.nih.gov]

  Histological Sections from Bilateral Adrenal Glands Demonstrated Nodular Hyperplasia The most frequent causes of hepatomegaly in a neonate include biliary tract obstruction, congestive heart failure, drugs, maternal diabetes, malnutrition, metabolic disorders, sepsis [ospublishers.com]

  Sepsis and cholestasis. Clin Liver Dis. 2008; 12(1):151-72. Tugwell P, Williams AO. Jaundice associated with lobar pneumonia. A clinical, laboratory and histological study. Q J Med. 1977; 46(181):97-118. Tiliakos N, Shamma’a JM, Nasrallah SM. [sapd.es]

  However, he developed liver and renal failure with associated sepsis. Despite maximal support, he succumbed two weeks afterwards because of multi-organ failure. [ijcasereportsandimages.com]

• Amyloidosis

  Br Med J. 1976; 1: 689-690 Scopus (10) PubMed Crossref Google Scholar Glenner G Amyloid deposits and amyloidosis. The β fibrilloses. [gastrojournal.org]

  壊血病 scorbutus 核黄疸 Kernikterus (独), kernicterus, nuclear jaundice 家族性アミロイドーシス familial amyloidosis 家族性アミロイドポリニューロパチー familial amyloidotic polyneuropathy 家族性LCAT欠損症 familial lecithin cholesterol acyltransferase deficiency 家族性高コレステロール血症 familial hypercholesterolemia [jsge.or.jp]

  Systemic amyloidosis complicated with peliosis. Ann Hemat 2009;88(9):917–20. [ CrossRef ] [ Pubmed ] Gushiken FC. Peliosis hepatis after treatment with 2-chloro-3`-deoxy-adenosine. [ijcasereportsandimages.com]

• Pathologist

  Awareness of peliosis at autopsy as well as an appreciation for the histopathological changes in less characteristic or advanced cases may become an important issue for both the forensic and clinical pathologist. [ncbi.nlm.nih.gov]

  Awareness of peliosis at autopsy as well as an appreciation for the histopathological changes in less characteristic or advanced cases may become an important issue for both the clinician and pathologist. [ospublishers.com]

  Pathologists originally classified peliotic lesions by the presence or absence of endothelium [1]. However, although the blood-filled cavities may have no endothelial lining, reendothelialization probably occurs rapidly. [ajronline.org]

  There are varying stages for this disease ranging from cystic dilatation to early organization of blood clot within the lesion and finally fibrous scar formation as described by some pathologists [ 29 ]. [omicsonline.org]

• Abdominal Pain

  A 35 year old woman with right upper quadrant abdominal pain was found to have peliosis hepatis. [ncbi.nlm.nih.gov]

  The presentation of PH is often non-specific, such as vague recurring abdominal pain. However it can also rarely have a potentially fatal presentation. [hpbonline.org]

• Nausea

  Case History, Patient 2 A 37-year-old woman presented with acute onset of epigastric and right upper quadrant pain, with associated nausea, vomiting and exacerbated gastroesophageal reflux. [file.scirp.org]

  She reported vague epigastric pains and nausea. She had no history of dark urine or hepatitis. She had a more than 30-year history of use of oral contraceptives as treatment of acne vulgaris. [njmonline.nl]

  The associated symptoms were nausea and vomiting. The patient did not report any fever, night sweating, jaundice, diarrhea, tarry stool, or body weight loss. [wjgnet.com]

• Vomiting

  A 3-year-11-month-old 22.5 kg female spayed mixed breed dog presented for progressive lethargy and vomiting. [northstarvets.com]

  Case History, Patient 2 A 37-year-old woman presented with acute onset of epigastric and right upper quadrant pain, with associated nausea, vomiting and exacerbated gastroesophageal reflux. [file.scirp.org]

  The associated symptoms were nausea and vomiting. The patient did not report any fever, night sweating, jaundice, diarrhea, tarry stool, or body weight loss. [wjgnet.com]

• Hepatomegaly

  On examination, there was hepatomegaly with liver showing dimensions15.4x10.2x9.4cm and weighed 252 grams. [ospublishers.com]

  The cause of the huge hepatomegaly encountered in the present case may be attributable to peliosis due to severe infection. [ncbi.nlm.nih.gov]

• Jaundice

  A 75-year-old man was admitted for evaluation of marked edema and jaundice. Serum total bilirubin was elevated above 20 mg/dl. [ncbi.nlm.nih.gov]

  Hepatic Adverse Effects-Prolonged use of high doses of orally active 17-alpha-alkyl androgens (e.g., methyltestosterone) has been associated with serious hepatic adverse effects (peliosis hepatis, hepatic neoplasms, cholestatic hepatitis, and jaundice [thefreedictionary.com]

  Some patients develop overt liver disease, characterized by jaundice, hepatomegaly, and liver failure. Mild cases may be detected incidentally during imaging tests done because liver test results are slightly abnormal or for other reasons. [merckmanuals.com]

  The patient will have jaundice and elevated serum transaminases. Left heart failure. There will be a low systemic blood pressure. [meddean.luc.edu]

• Prolapse

  Bowel obstruction ( Intussusception, Volvulus ) - Diverticulitis / Diverticulosis - IBS other functional intestinal disorders ( Constipation, Diarrhea, Megacolon / Toxic megacolon, Proctalgia fugax ) - Anal fissure / Anal fistula - Anal abscess - Rectal prolapse [bionity.com]

• Dark Urine

  She had no history of dark urine or hepatitis. She had a more than 30-year history of use of oral contraceptives as treatment of acne vulgaris. [njmonline.nl]

Hematologic workup was compatible with peripheral sequestration or loss of blood cells; however, there was no evidence of gastrointestinal or other sources of hemorrhage, and the only significant finding was a progressive liver enlargement. [ncbi.nlm.nih.gov]

• Enlargement of the Liver

  There may be enlargement of the liver, lymph nodes or spleen. Endocarditis is sometimes associated with Bartonella spp. infection (including B. henselae, B. quintana, Bartonella elizabethae ). [patient.info]

• Hypoalbuminemia

  Laboratory diagnosis Abnormal liver biochemical test levels can be the initial presentation but the thrombocytopenia, hypoalbuminemia and hyperbilirubinemia can be founded when portal hypertension and hepatic failure develop. [wjgnet.com]

• Colitis

  IBD (Crohn's, Ulcerative colitis ) - noninfective gastroenteritis Other intestinal vascular ( Abdominal angina, Mesenteric ischemia, Ischemic colitis, Angiodysplasia ) - Ileus / Bowel obstruction ( Intussusception, Volvulus ) - Diverticulitis / Diverticulosis [bionity.com]

  J Crohn's Colitis 2011; 5 :48–53. [ PubMed ] [ Google Scholar ] [8] Grønlykke L, Tarp B, Dutoit SH, Wilkens R. Peliosis hepatis: a complicating finding in a case of biliary colic. [ncbi.nlm.nih.gov]

  J Crohns Colitis. 5(1):48–53. Elsing C, Placke J, Herrmann T. (2007). Alcohol binging causes peliosis hepatis during azathioprine therapy in Crohn’s disease. World J Gastroenterol. 13(34):4646–8. [mathewsopenaccess.com]

  J Crohn's Colitis 2011;5:48–53. [8]. Grønlykke L, Tarp B, Dutoit SH, Wilkens R. Peliosis hepatis : a complicating finding in a case of biliary colic. BMJ Case Rep 2013;2013:pii: bcr2013200539. [9]. Testa G, Panaro F, Sankary H, et al. [journals.lww.com]

• Lymph Node Hyperplasia

  A review is presented of the cutaneous manifestations of giant lymph node hyperplasia. [ncbi.nlm.nih.gov]

• Liver Biopsy

  The liver biopsy under laparoscopy revealed marked sinusoidal dilatation and retention of red blood cells, which was consistent with a diagnosis of peliosis hepatis. [ncbi.nlm.nih.gov]

  A Fatal Case of Intra-Abdominal Hemorrhage Following Diagnostic Blind Percutaneous Liver Biopsy in a Patient With Peliosis Hepatis Abstract Peliosis hepatis (PH) is a rare vascular condition of the liver characterized by the presence of cystic blood filled [gastrores.org]

• Hepatocellular Carcinoma

  The lesion was diagnosed and treated as a small hepatocellular carcinoma. However, subsequent right hepatic lobectomy and histologic examination confirmed the diagnosis of focal peliosis hepatis. [ncbi.nlm.nih.gov]

  South-East Asia is an epidemic area for hepatocellular carcinoma and therefore, the diagnosis based on the CT scan at the time of presentation was ruptured hepatocellular carcinoma. Treatment options are determined by the underlying cause. [ijcasereportsandimages.com]

  Differential diagnosis Hemangioma: Discrete lesion with fibrous tissue in background, linking the engorged spaces Kaposi sarcoma: Can mimic bacillary peliosis but vessels are less well formed HHV8 positive Peliotic change in hepatocellular carcinoma: [pathologyoutlines.com]

• Leukocytosis

  The laboratory findings showed mild leukocytosis (11.2×10 3 cells/µL) and an elevated C-reactive protein level, and the hepatic parameters were markedly elevated. The serum hemoglobin level was 7.8 g/dL and she was transfused with whole blood. [synapse.koreamed.org]

  Lab work revealed leukocytosis with neutrophilia, hemoglobin 12.8 g/dl, normal coagulation times and a pattern of cholestasis. [elsevier.es]

We suggest avoiding or interrupting treatment with androgens in patients preparing for BMT. [ncbi.nlm.nih.gov]

Prognosis Usually self-limiting. Trench fever re-infection may occur within 3-6 months because antibodies do not give full protection. [patient.info]

Even though liver histology could have made a definite diagnosis of PH, it would not have had an added benefit to the treatment of the patient or her overall prognosis. [mathewsopenaccess.com]

It results in a major hypotonia with respiratory attack, the whole quickly putting into play the vital prognosis. [institut-myologie.org]

[…] blood in these regions.[9] The radiographic differential includes: Polycystic liver disease Congenital hepatic fibrosis Solitary congenital cysts Hydatid cyst Von Meyenburg complexes Caroli disease (type V choledochal cyst) Type IV choledochal cysts Prognosis [ncbi.nlm.nih.gov]

We report the CT, angiographic and MR features of a case of peliosis hepatis with no obvious etiology and spontaneously regressing hemorrhagic necrosis. [ncbi.nlm.nih.gov]

Definition / general Multiple blood filled cysts in liver, with several potential causes Essential features Blood filled hepatic spaces of various sizes, usually discovered by radiology or at autopsy Several possible etiologies, including Bartonella henselae [pathologyoutlines.com]

EPIDEMIOLOGY The epidemiology of peliosis hepatis is incompletely understood since many patients are asymptomatic and remain undiagnosed. Peliosis hepatis is often an incidental finding on abdominal imaging or autopsy. [uptodate.com]

Peliosis hepatis Microchapters Home Patient Information Overview Historical Perspective Classification Pathophysiology Causes Differentiating Peliosis hepatis from Other Diseases Epidemiology and Demographics Risk Factors Screening Natural History, Complications [wikidoc.org]

"Molecular epidemiology of bartonella infections in patients with bacillary angiomatosis-peliosis". N. Engl. J. Med. 337 (26): 1876–83. doi:10.1056/NEJM199712253372603. [en.wikipedia.org]

Describe the pathophysiology of peliosis hepatis. Identify imaging modalities to evaluate patients with suspected peliosis hepatis. [ncbi.nlm.nih.gov]

The main aim is to prevent the risk of a sudden bleeding that, in absence of properly equipped structures, may have a fatal outcome. [ncbi.nlm.nih.gov]

Surgical intervention is the main treatment to prevent massive hemorrhage from cystic rupture and progression into hepatic failure (3). If etiology is suspected to be drug-induced, stopping the offending agent is indicated (2). [journal.chestnet.org]

Secondary Prevention Cost-Effectiveness of Therapy Future or Investigational Therapies Case Studies Case #1 Peliosis hepatis overview On the Web Most recent articles Most cited articles Review articles CME Programs Powerpoint slides Images American Roentgen [wikidoc.org]

We decided to operate by means of diagnostic and therapeutic means by which we could prevent future bleeding complications. [wjgnet.com]