Chronic graft-versus-host disease after hematopoietic cell transplantation presenting as an acute hepatitis.
A variety of illnesses involving the gut and liver follow hematopoietic cell transplantation (HCT). A 20 yr-old white male developed severe acute hepatitis 36 wk (day 252) after matched, unrelated, allogeneic HCT for chronic myelogenous leukemia (CML). Mild skin graft-versus-host disease (GVHD) had occurred at about 20 wk (day 140) after transplant. Liver biopsy showed bile duct injury and a diffuse lobular injury pattern most consistent with a GVHD variant and not reminiscent of drug-induced or viral hepatitis. No findings suggestive of herpesvirus, adenovirus, or varicella-zoster virus were found. High-dose steroids resulted in marked improvement of his liver enzyme levels. We report this patient as representing the acute hepatitic presentation of chronic GVHD of the liver.
Department of Internal Medicine, University of Texas Southwestern Medical Center, Dallas 75390-9151, USA.
A H
AH
Malik
R H
RH
Collins
M H
MH
Saboorian
W M
WM
Lee
D000208:Acute Disease; D000328:Adult; D001706:Biopsy; D002908:Chronic Disease; D006086:Graft vs Host Disease / Q000150:complications*; D018380:Hematopoietic Stem Cell Transplantation / Q000009:adverse effects; D006505:Hepatitis / Q000188:drug therapy / Q000209:etiology* / Q000473:pathology; D006801:Humans; D015464:Leukemia, Myelogenous, Chronic, BCR-ABL Positive / Q000628:therapy; D008099:Liver / Q000473:pathology; D008297:Male; D011241:Prednisone / Q000627:therapeutic use; D013997:Time Factors
D011241:Prednisone