Peliosis Hepatis and Cholestasis Following Administration of Norethandrolone

Pathology of peliosis

“…As a matter of fact, tuberculosis was replaced by the acquired immunodeficiency syndrome (AIDS) or post-transplant immunodeficiency in more recent publications [5,21]. However, most frequently, peliosis has been reported to occur with the chronic intake of oral contraceptives or anabolic androgenic steroids, the latter mainly used in this context as performance-enhancing drugs [2,[25][26][27][28][29][30][31]. Several theories concerning the formal pathogenesis of hepatic peliosis have been discussed.…”

“…In most cases reported, peliosis of the liver was a pure incidental finding in surgical specimens or at autopsy [2,11,12,14,23,30], whereas in a paucity of studies, liver failure as the primary cause of death has been attributed directly to peliosis hepatis [2,25]. In addition, rupture of the peliotic liver lesions may occur, thus leading to intraperitoneal hemorrhage with potential fatal outcome [32][33][34][35].…”

“…The diagnosis of peliosis may be occasionally established at autopsy by the unique gross appearance of multiple cyst-like, blood-filled cavities on cut-surfaces of the affected organ, but usually the disease is a histological diagnosis [2][3][4][5][6][7]. Peliosis has been Forensic Science International 149 (2005) [25][26][27][28][29][30][31][32][33] related to several underlying debilitating illnesses or medications, and different theories have been proposed concerning the pathogenesis of this unique disorder over the years. While some investigators favour congenital malformation of vessels or microcirculatory disturbances manifesting under altered local intravascular pressure conditions as responsible for the development of the disease [4,[8][9][10], others believe that an acquired vascular disorder triggered by toxic noxae may play a key role in the pathogenesis [11,12].…”

Spontaneous rupture of a liver cell adenoma after long term Methyltestosterone: Report of a case successfully treated by emergency right hepatic lobectomy

“…Peliosis hepatis has been reported after the use of norethandrolone, oxymetholone and methyltestosterone (Gordon , 1960;Bernstein et al, 1971;Westaby et al, 1977). In 1974 Bagheri and Boyer described 7 cases of peliosis hepatis in patients treated with anabolicandrogenic steroids.…”

Hyperplasia and prolapse of hepatocytes into hepatic veins during longterm methyltestosteronetherapy: possible relationships of these changes to the development of peliosis hepatis and liver tumours

“…It was first described by Wagner (1861) and until recently most cases were diagnosed in necropsy material from patients who had died from pulmonary tuberculosis, disseminated neoplasia or long-standing wasting conditions (Zak 1950), but in many recently reported cases the patients had received 17-alkylated synthetic androgens ( Table 2 ) . The pathogenesis of peliosis is not known and the many theories proposed (see Gordon, Wolf, Krause & Shai 1960) are not substantiated by observations. It is possible that the pathogenesis of peliosis may be different in different conditions.…”