Splenic Peliosis in a Patient with Aplastic Anemia during Danazol Therapy


We experienced a case of danazol-induced splenic peliosis. A 42-year-old woman had taken danazol for refractory aplastic anemia for 2 years. Her anemia gradually became aggravated, and the patient complained of intermittent left upper-abdominal pain. Because computed tomography scanning showed multiple blood-filled cavities in the enlarged spleen without intraperi-toneal hemorrhage, a splenectomy was emergently performed. This report is the first of a case of splenic peliosis developing during danazol therapy for aplastic anemia. The possible association between the administration of anabolic steroids or danazol and the development of peliosis is discussed.

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  1. 1.

    Lacson A, Berman LD, Neiman RS. Peliosis of the spleen.Am J Clin Pathol. 1979;71:586–590.

    Article  PubMed  CAS  Google Scholar 

  2. 2.

    Tada T, Wakabayashi T, Kishimoto H. Peliosis of the spleen.Am J Clin Pathol. 1983;79:708–713.

    Article  PubMed  CAS  Google Scholar 

  3. 3.

    Wold LE, Ludwig J. Peliosis hepatis: two morphologic variants?Hum Pathol. 1981;12:388–389.

    Article  Google Scholar 

  4. 4.

    Solis-Herruzo JA, Colina F, Muñoz-Yagüe MA, Castellano G, Morillas JD. Reddish-purple areas on the liver surface: the laparoscopic picture of peliosis hepatis.Endoscopy. 1983;15:96–100.

    Article  PubMed  CAS  Google Scholar 

  5. 5.

    Benjamin DR, Shunk B. A fatal case of peliosis of the liver and spleen.Am J Dis Child. 1978;132:207–208.

    PubMed  CAS  Google Scholar 

  6. 6.

    Hirose H, Ohishi A, Nakamura H, Sugiura H, Umezawa A, Hosoda Y. Fatal splenic rupture in anabolic steroid-induced peliosis in a patient with myelodysplastic syndrome.Br J Haematol. 1991;78:128–129.

    Article  PubMed  CAS  Google Scholar 

  7. 7.

    Makdisi WJ, Cherian R, Vanveldhuizen PJ, Talley RL, Stark SP, Dixon AY. Fatal peliosis of the liver and spleen in a patient with agno-genic myeloid metaplasia treated with danazol.Am J Gastroenterol. 1995;90:317–318.

    PubMed  CAS  Google Scholar 

  8. 8.

    Tsuda K, Nakamura H, Murakami T, et al. Peliosis of the spleen with intraperitoneal hemorrhage.Abdom Imaging. 1993;18:283–285.

    Article  PubMed  CAS  Google Scholar 

  9. 9.

    Shimono T, Yamaoka T, Nishimura K, et al. Peliosis of the spleen: splenic rupture with intraperitoneal hemorrhage.Abdom Imaging. 1998;23:201–202.

    Article  PubMed  CAS  Google Scholar 

  10. 10.

    Despert F, Lamagnere JP, Chantepie A, Grangeponte MC, Lejars O, Combe P. Fanconi’s disease associated with hepato-splenic peliosis [in French].Arch Fr Pediatr. 1981;38:29–33.

    PubMed  CAS  Google Scholar 

  11. 11.

    Maves CK, Caron KH, Bisset GS 3rd, Agarwal R. Splenic and hepatic peliosis: MR findings.AJR Am J Roentgenol. 1992;158:75–76.

    Article  PubMed  CAS  Google Scholar 

  12. 12.

    Nesher G, Dollberg L, Zimran A, Hershko C. Hepatosplenic peliosis after danazol and glucocorticoids for ITP.N Engl J Med. 1985;312:242–243.

    PubMed  CAS  Google Scholar 

  13. 13.

    Cassi E, De ’Paoli A, Tosi A. Splenic peliosis after danazol therapy for idiopathic thrombocytopenic purpura (ITP).Haematologica. 1985;70:549–550.

    PubMed  CAS  Google Scholar 

  14. 14.

    Javier Peñ alver F, Somolinos N, Villanueva C, Sánchez J, Monteagudo D, Gallego R. Splenic peliosis with spontaneous splenic rupture in a patient with immune thrombocytopenia treated with danazol.Haematologica. 1998;83:666–667.

    Google Scholar 

  15. 15.

    Varo MJ, Palomera L, Domingo JM, Soria J. Spontaneous splenic rupture caused by spleen peliosis in a patient with autoimmune thrombocytopenic purpura treated with danazol [in Spanish].Med Clin (Barc). 2000;114:759.

    Article  PubMed  CAS  Google Scholar 

  16. 16.

    Taxy JB. Peliosis: a morphologic curiosity becomes an iatrogenic problem.Hum Pathol. 1978;9:331–340.

    Article  CAS  Google Scholar 

  17. 17.

    Slater D, Parsons A, Platts M, Fox M. Peliosis in renal failure treated with androgens.N EnglJ Med. 1981;305:345.

    CAS  Google Scholar 

  18. 18.

    Leong SS, Cazen RA, Yu GS, LeFevre L, Carson JW. Abdominal visceral peliosis associated with bacillary angiomatosis: ultrastructural evidence of endothelial destruction by bacilli.Arch Pathol Lab Med. 1992;116:866–871.

    CAS  Google Scholar 

  19. 19.

    Gugger M, Gebbers JO. Peliosis of the spleen: an immune-complex disease?Histopathology. 1998;33:387–389.

    Article  CAS  Google Scholar 

  20. 20.

    Wong AK, Alfert M, Castrillon DH, et al. Excessive tumor-elaborated VEGF and its neutralization define a lethal paraneoplastic syndrome.ProcNatlAcadSci USA. 2001;98:7481–7486.

    Article  CAS  Google Scholar 

  21. 21.

    Liu D, Si H, Reynolds KA, Zhen W, Jia Z, Dillon JS. Dehy-droepiandrosterone protects vascular endothelial cells against apoptosis through a G?i protein-dependent activation of phos-phatidylinositol 3-kinase/Akt and regulation of antiapoptotic Bcl-2 expression.Endocrinology. 2007;148:3068–3076.

    Article  PubMed  CAS  Google Scholar 

  22. 22.

    Simoncini T, Mannella P, Fornari L, Varone G, Caruso A, Genazzani AR. Dehydroepiandrosterone modulates endothelial nitric oxide synthesis via direct and nongenomic mechanisms.Endocrinology. 2003;144:3449–3455.

    Article  PubMed  CAS  Google Scholar 

  23. 23.

    Carlström K, Döberl A, Rannevik G. Peripheral androgen levels in danazol-treated premenopausal women.Fertil Steril. 1983;39:499–504.

    Article  PubMed  Google Scholar 

  24. 24.

    Murakami K, Nakagawa T, Yamashiro G, Araki K, Akasofu K. Levels of androgens and danazol metabolites in serum during danazol therapy.Fertil Steril. 1993;60:179–181.

    Article  PubMed  CAS  Google Scholar 

  25. 25.

    Winkler UH. Effects of androgens on haemostasis.Maturitas. 1996;24:147–155.

    Article  PubMed  CAS  Google Scholar 

  26. 26.

    Tripodi A, Chantarangkul V, Martinelli I, Bucciarelli P, Mannucci PM. A shortened activated partial thromboplastin time is associated with the risk of venous thromboembolism.Blood. 2004;104:3631–3634.

    Article  PubMed  CAS  Google Scholar 

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Correspondence to Shunya Arai or Takashi Asai or Hiroshi Uozaki or Akira Hangaishi or Yoshinobu Kanda or Toru Motokura or Shigeru Chiba or Mineo Kurokawa.

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Arai, S., Asai, T., Uozaki, H. et al. Splenic Peliosis in a Patient with Aplastic Anemia during Danazol Therapy. Int J Hematol 86, 329–332 (2007). https://doi.org/10.1532/IJH97.07078

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Key words

  • Spleen
  • Peliosis
  • Danazol
  • Anabolic steroid
  • Aplastic anemia