title: Intrahepatic cholestasis due to systemic mastocytosis: a case report and review of literature.
abstract: A 35-yr-old female presented with symptoms of obstructive jaundice. Liver biopsy, bone marrow aspiration, and biopsy revealed systemic mastocytosis and acute myeloid leukemia. The liver biopsy specimen showed infiltration of mast cells within portal tracts with periductal and portal edema, irregularity of interlobular duct epithelium, and centrizonal cholestasis. Endoscopic retrograde cholangiography was normal. Following chemotherapy treatment with idarubicin and cytarabine for seven days for AML, the bilirubin levels continued to increase for two weeks and then decreased, reaching normal levels in two months. Infiltration of mast cells in the liver leads to hepatomegaly, liver function abnormality and rarely portal hypertension. Intrahepatic cholestasis due to systemic mastocytosis has never been reported. We report a rare case of systemic mastocytosis causing intrahepatic cholestasis that resolved with remission of AML following chemotherapy.
authors.affiliation: Department of Medicine, School of Medicine, University of Pittsburgh, Mercy Hospital, Pennsylvania, USA.
authors.forename: E L
authors.initials: EL
authors.lastname: Safyan
authors.forename: M P
authors.initials: MP
authors.lastname: Veerabagu
authors.forename: S H
authors.initials: SH
authors.lastname: Swerdlow
authors.forename: R G
authors.initials: RG
authors.lastname: Lee
authors.forename: J
authors.initials: J
authors.lastname: Rakela
mesh_terms: D000328:Adult; D000971:Antineoplastic Combined Chemotherapy Protocols / Q000627:therapeutic use; D001853:Bone Marrow / Q000187:drug effects / Q000473:pathology; D002780:Cholestasis, Intrahepatic / Q000209:etiology* / Q000473:pathology; D003937:Diagnosis, Differential; D005260:Female; D006801:Humans; D015470:Leukemia, Myeloid, Acute / Q000150:complications* / Q000175:diagnosis* / Q000188:drug therapy / Q000473:pathology; D008415:Mastocytosis / Q000150:complications* / Q000175:diagnosis* / Q000209:etiology / Q000473:pathology; D012074:Remission Induction