DIFFUSE NODULAR REGENERATIVE HYPERPLASIA OF THE LIVER ASSOCIATED WITH HUMAN-IMMUNODEFICIENCY-VIRUS AND VISCERAL LEISHMANIASIS

We present a patient with human immunodeficiency virus (HIV) infection coincident with diffuse nodular regenerative hyperplasia (DNRH) of the liver and visceral leishmaniasis. This association has not been previously described. Some DNRH cases are secondary to irregular blood flow in the liver. In the presently described case, there exist two possible conditioning factors for heterogenous distribution of blood flow: 1) the increased blood flow from splenomegaly, and 2) the irregular circulation of blood through sinusoids infiltrated by Leishmania-parasitized hyperplastic macro phages.