The relationship between estrogen and the development of liver vascular disorders

The liver is central to the metabolic disposition of all drugs and foreign substance. Drug-induced liver injury is a potential complication of estrogen preparations. The primary estrogen-induced vascular disorders are peliosis hepatis and vasculitis. Peliosis hepatis has been described as a rare consequence of taking estrogens and contraceptive. This condition is characterized by the presence of blood-filled spaces. Vasculitis has been noted as necrotizing or non-necrotizing hypersensitivity and an inflammatory infiltrate involving all the wall of a vessel. Vasculitis is usually connected with the presence of increased numbers of eosinophils either in blood or tissues. The aim of the study was to determine the influence of estrogen preparations on liver vascular disorders. The experiment was conducted on female rats of Wistar strain with the initial body weight of 180-300 g/kg of the body weight. After acclimation period, animals were gathered in 5 experimental groups of min. 10 in the group. Oestradiolum benzoicum was used for the purpose of this study. It was given i.m. once a week for 8 weeks in three different doses: E1--0.0075 g/kg, E2--0.0015 g/kg; E3--0.003 g/kg of the body weight. Two control groups were designed: K0--the untreated animals, K1--the animals receiving the adequate quantity of oleum pro injection. Fragments of organ assigned for histological examination were fixed in 10% buffered formaldehyde solution and transformed into paraffin sections. Histological preparations were evaluated in the light microscope. The histological assays were determined using: hematoxylin-eosin, azan and histochemical paS (periodic acid-Schiff) stains. In the described experiment large inflammatory infiltrations and vasculitis (E2, E3) were observed. In the animals treated with higher doses of estrogens diffusely distributed infiltrations around spaces with bloody fluid inside were revealed. The lumen of vessels was dilated. Estrogens can be responsible for the development of vascular disorders described as peliosis hepatis. The observed changes were suggestive of drug related vasculitis. An increased awareness of peliosis hepatis may become an important symptom for a pathologist, especially in patients at risk.