Peliosis Hepatis Associated with Androgenic-Anabolic Steroid Therapy: A Severe Form of Hepatic Injury

Abstract

Blood-filled cysts, characteristic of peliosis hepatis, developed within hepatic parenchyma in seven patients who were treated with androgenic-anabolic steroids for periods ranging from 2 to 27 months. Five patients had hematologic disorders, and two had malignancies. Although liver function was normal in all patients before therapy was started, all but one patient developed hepatomegaly or signs of hepatic toxicity. Two patients sustained intraperitoneal hemorrhages from the peliotic lesions, and one died from shock. Peliosis hepatis resulted in hepatic failure and death in three patients, with terminal renal failure supervening in two. The spectrum of histologic abnormalities in these patients suggested that the hemorrhagic cysts developed from focuses of hepatocellular necrosis. These studies indicate that peliosis hepatis can be a serious life-threatening complication of androgenic-anabolic steroid therapy in man.