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A Histopathologic Classification of Chemical-Induced Injury of the Liver
Published in Robert G. Meeks, Steadman D. Harrison, Richard J. Bull, Hepatotoxicology, 2020
John M. Cullen, Boris H. Ruebner
Peliosis hepatis is a striking hepatic lesion which may or may not be associated with symptoms. It is seen most characteristically in humans as the result of ingestion of contraceptive or androgenic steroid hormones (Taxy, 1978). It consists of the development of large irregular vascular spaces in the liver which may or may not be lined by endothelium (Figure 9). These spaces have no preferential lobular localization. Whether these vascular spaces are associated with necrosis remains debated. Most similar to the human disease is probably St. George’s disease of cattle caused by a poisonous plant, Pimella spp (Kelly and Seawright, 1978). Somewhat similar lesions were seen after administration of lasiocarpine in mice by Ruebner (Ruebner et al., 1970) and after phalloidin exposure in the rat (Tuchweber et al., 1973).
Diseases of the Hepatobiliary Tree and Pancreas Associated with Fever
Published in Benedict Isaac, Serge Kernbaum, Michael Burke, Unexplained Fever, 2019
Hepatobiliary involvement in AIDS133,134 is quite complex and may be due to many causes. Fever is frequently present. Hepatic dysfunction with or without jaundice may be related to concomitant viral infection, for example, HBV or EBV, or to opportunistic infectious agents, including Mycobacterium avium-intracellulare, fungi, or CMV. In addition, these features may be associated with “opportunistic” tumors, including Kaposi’s sarcoma, lymphoma, or angiosarcoma of the liver. Peliosis hepatis may also be found.
Anabolic–Androgenic Steroids
Published in Frank A. Barile, Barile’s Clinical Toxicology, 2019
More severe warnings associated with steroid use include the development of peliosis hepatis—a liver condition characterized by the replacement of liver cells with blood-filled cysts. The disorder is reversible on discontinuation of drug use. Peliosis hepatis usually presents with minimal, unrecognized hepatic dysfunction until life-threatening liver failure or intra-abdominal hemorrhage occurs. Benign, androgen-dependent hepatic tumors have been noted. The vascularized tumors are relatively uncommon neoplastic occurrences in humans in the absence of steroid use. With continuous misuse of steroids, the tumors develop undetected until life-threatening intra-abdominal hemorrhage ensues. Increased risk of atherosclerosis and coronary artery disease is associated with chronic abuse resulting from blood lipid changes (decreased high-density lipoproteins). Hypopituitarism results from AAS abuse and is characterized by diminution or cessation of function of the adenohypophysis. Major consequences occur as a result of variable deficiency of gonadotropins (sex hormones), somatotropins (growth hormones), thyrotropin (thyroid hormones), and corticotropin (corticosteroid hormones). Table 19.2 summarizes general and age- and gender-specific effects of AAS abuse.
International Society for the Study of Women's Sexual Health Clinical Practice Guideline for the Use of Systemic Testosterone for Hypoactive Sexual Desire Disorder in Women
Published in Climacteric, 2021
Sharon J. Parish, James A. Simon, Susan R. Davis, Annamaria Giraldi, Irwin Goldstein, Sue W. Goldstein, Noel N. Kim, Sheryl A. Kingsberg, Abraham Morgentaler, Rossella E. Nappi, Kwangsung Park, Cynthia A. Stuenkel, Abdulmaged M. Traish, Linda Vignozzi
In a meta-analysis of 36 trials enrolling 8,480 women with duration of 12 weeks–2 years, testosterone administration (oral preparations in approximately half the trials; IM injection, subcutaneous pellets, and transdermal preparations in the remainder) increased the risk of developing acne (relative risk 1.46; 95% confidence interval [CI] 1.11–1.92) and hair growth (relative risk 1.69; 95% CI 1.33–2.14) [5]. Findings were comparable with a prior meta-analysis [111]. No significant improvement was noted for bone mineral density, body composition, or cognitive measures, although an overall increase in weight was recorded with testosterone treatment [5]. Lipid effects included reduction in total cholesterol, high-density lipoprotein cholesterol, and triglyceride levels along with a statistically significant increase in low-density lipoprotein cholesterol with oral but not with transdermal testosterone preparations [5,97,111]. Also, these older oral formulations are no longer recommended because of concerns with negative hepatic effects such as peliosis hepatis and hepatic neoplasms including hepatocellular carcinoma [112,113].