What is 'Peliosis hepatis' can be caused by the following except: and explain in detail?
Ans. A. Analgesics. (Ref. H - 17th/pg. 988, 1950)Peliosis hepatis (blood cysts of the liver), has been observed in some patients treated with anabolic steroids.Certain drugs appear to be responsible for the development of chronic as well as acute hepatic injury. For example,:DRUGLiver-related Side-effects1 Oxyphenisatin, Methyldopa, and isoniazid- Moderate to severe chronic hepatitis, and cirrhosis.2 Halothane and methotrexate+3 Chlorpromazine, methyl testosterone, tolbutamide, etc- Syndrome resembling primary biliary cirrhosis (Biliary cholestatic jaundice)4 Vitamin A or arsenic intoxication, vinyl chloride, or othorium dioxide.- Portal hypertension in the absence of cirrhosis5 Arsenic intoxication, industrial exposure to vinyl chloride, or administration of thorium dioxide- angiosarcoma of the liver.6 Oral contraceptives- hepatic adenoma and, rarely,- HCC and hepatic vein occlusion (Budd-Chiari).7 Peliosis hepatis (blood cysts of the liver)anabolic steroids, OC pills and Danazol.Additional Educational points:B. henselae and B. quintana can cause a broad spectrum of disease in HIV-infected individuals, including bacillary angiomatosis, peliosis hepatis, osteomyelitis, unexplained fever, bacteremia, and endocarditis. Bacillary angiomatosis is the most common of these manifestations.# Drug-induced cholestasis ranges from mild to increasingly severe:- (1) bland cholestasis with limited hepatocellular injury (e.g., estrogens, 17,?-substituted androgens);- (2) inflammatory cholestasis (e.g., phenothiazines, amoxicillin-clavu'anic acid, oxacillin, erythromycin estolate);- (3) sclerosing cholangitis (e.g., after intrahepatic infusion of the chemotherapeutic agent floxuridine for hepatic metastases from a primary colonic carcinoma);- (4) disappearance of bile ducts, "ductopenic" cholestasis, similar to that observed in chronic rejection following liver transplantation (e.g., carbamazepine, chlorpromazine, tricyclic antidepressant agents).# Cholestasis may result from some drugs with typical features like bridging hepatic necrosis (e.g., methyldopa), or hepatic granulomas (e.g., sulfonamides).0# Severe hepatotoxicity with steatohepatitis, a result of reversible mitochondrial toxicity, is known with antiretroviral agents like reverse transcriptase inhibitors (e.g., zidovudine, didanosine) or protease inhibitors (e.g., indinavir, ritonavir).# Potential target for idiosyncratic drug hepatotoxicity is sinusoidal lining cells as by high- dose chemotherapeutic agents (e.g., cyclophosphamide, melphalan, busulfan), which can cause venoocclusive.