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高催乳素血症合并肝紫癜:一例报告并文献复习

Hyperprolactinemia complicated with peliosis hepatis: One case report and review of literature.

作者信息

Li Xun, Lv Yang, Xia Yu, Lai Yulian, Chen Shangbin, Xie Yinzi, Tang Ziwei, Cheng Qingfeng

机构信息

Department of Endocrinology, The First Affiliated Hospital of Chongqing Medical University, Chongqing, China.

Wuzhou Medical College, Wuzhou of Guangxi Zhuang Autonomous Region, Wuzhou, China.

出版信息

Medicine (Baltimore). 2025 Jan 10;104(2):e41168. doi: 10.1097/MD.0000000000041168.

Abstract

RATIONALE

Peliosis hepatis (PH) is a rare disease with few clinical reports and complex etiology. However, there have been no reports of hyperprolactinemia (HPRL) leading to PH at present. This paper, through case reports, expands the understanding of the etiology of PH and the pathological damage effect of prolactin (PRL).

PATIENT CONCERNS

The patient reported in this paper had jaundice, menstrual disorders, menopause, weight gain, and other symptoms. Laboratory examination found increased levels of PRL and transaminase in liver function, and imaging examination indicated pituitary tumor and PH.

DIAGNOSES

Comprehensive patient history and auxiliary examination, the clinical diagnosis was pituitary PRL tumor and PH.

INTERVENTIONS AND OUTCOMES

After treatment with bromocriptine, menstruation recovered and liver function returned to normal. In addition, the follow-up imaging examination indicated that pituitary tumors and PH lesions were shrinking, and clinical phenomena indicated that HPRL caused by pituitary prolactinoma was correlated with PH occurrence.

LESSONS

Since there is no report of HPRL causing PH, the specific pathogenesis is unknown. This paper reviews the relevant literature and puts forward the theoretical consideration of the pathogenesis. Through this case, for clinically similar patients, it is warned that we need to consider the possibility of PH and further improve the examination, evaluation and treatment in time.

摘要

理论依据

肝紫癜病(PH)是一种罕见疾病,临床报道较少且病因复杂。然而,目前尚无高催乳素血症(HPRL)导致PH的报道。本文通过病例报告,拓展了对PH病因及催乳素(PRL)病理损伤作用的认识。

患者情况

本文报道的患者有黄疸、月经紊乱、闭经及体重增加等症状。实验室检查发现PRL水平升高及肝功能中转氨酶升高,影像学检查提示垂体瘤及PH。

诊断

综合患者病史及辅助检查,临床诊断为垂体PRL瘤及PH。

干预措施及结果

经溴隐亭治疗后,月经恢复且肝功能恢复正常。此外,随访影像学检查显示垂体瘤及PH病灶缩小,临床现象表明垂体催乳素瘤所致HPRL与PH发生相关。

经验教训

由于尚无HPRL导致PH的报道,其具体发病机制尚不清楚。本文复习相关文献并提出发病机制的理论思考。通过该病例,警示临床类似患者需考虑PH的可能性并及时完善检查、评估及治疗。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/dfbe/11729150/406f3141274f/medi-104-e41168-g001.jpg

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