[Perisinusoidal fibrosis in idiopathic thrombopenic purpura]

Perisinusoidal fibrosis of the liver was discovered in a 22 year-old woman with idiopathic thrombocytopenic purpura requiring splenectomy. No etiology of fibrosis could be found. As shown by immunocytochemistry, collagen types I, III, IV, laminin, and fibronectin were increased. Under electron microscopy, numerous collagen bundles and fragments of basement membrane-like material were demonstrated. Perisinusoidal cells loaded with lipids showed several of the characteristics of fibro/myofibroblasts, while the activity and number of Kupffer cells were apparently increased. The exact mechanism of fibrosis in this case remains unknown but it is likely that platelet destruction and/or Kupffer cell hyperactivity played a role.