Peliosis hepatis is characterized by hepatic sinusoidal dilatation and multiple blood-filled cystic cavities within the liver parenchyma. It can be due to
infectious diseases, immunological disorders,
neoplasia, and the use of various kinds of drugs. We presented the case of a nonsmoker 55-year-old man who complained about a 5-month history of
arthritis. Medical history was consistent with
psoriasis and
hypertension. He denied any
drug use or alcohol consumption. Physical examination showed extended psoriatic lesions. He had
arthritis of the knees, ankles, wrists, and elbows. His body mass index was 22 kg/m2. Laboratory findings revealed an increased serum gamma-glutamyl
transferase level (1014 UI/L, normal value (N) 11-55) and total
alkaline phosphatase (278 U/L,
N 30-171).
Hepatitis A, B, and C serologic test results were negative. Anti-nuclear
antibodies, anti-Ro/SSA, anti-GP210, anti-SP100, anti-SLA, anti-LKM1, anti-M2,
anti-LC1, and anti-PML were also negative. Histopathological examination of a liver biopsy specimen revealed
peliosis hepatis.The pelvic radiograph showed bilateral
ankylosis of sacroiliac joints. Hand and foot radiographs showed periosteal bone apposition. The diagnosis of
psoriatic arthritis associated with
peliosis hepatis was made. The patient received
infliximab (5 mg/kg) with a significant improvement after 3 months of follow-up.
Peliosis hepatis should be considered as a possible etiology of liver
enzyme abnormalities in patients with
psoriatic arthritis. We highlighted the effectiveness and safety of the
TNF inhibitors in the treatment of
peliosis hepatis associated with
psoriatic arthritis. Key Points •
Peliosis hepatis should be considered as a possible etiology of liver
enzyme disturbance in patients with
psoriatic arthritis. • Special caution should be advised in the management of
psoriatic arthritis associated with
peliosis hepatis to avoid the worsening of liver function. •
Infliximab is suggested as a possible treatment of
peliosis hepatis associated with
psoriatic arthritis.