Autoimmune hepatitis following allogeneic PBSCT from an HLA-matched sibling.
A 7-year-old boy with acute lymphoblastic leukemia (ALL) in second remission received an allogeneic PBSCT from his HLA-matched sister. Acute grade II graft-versus-host disease (GVHD) resolved with corticosteroids. Chronic GVHD in the skin and oral mucosa at around day 60 responded to corticosteroids and cyclosporin A. At 6 months after the transplant, he developed hepatic dysfunction with elevated serum transaminases and gamma-globulin. Liver biopsy revealed chronic inflammation with lymphocytes and plasma cells in portal areas without destruction of bile ducts, suggesting autoimmune hepatitis. While rare, autoimmune hepatitis should be considered a potential long-term complication in patients with hepatic dysfunction in the late post-transplant phase.
Department of Pediatrics, University of Tokushima School of Medicine, Japan.
T
T
Ogose
T
T
Watanabe
H
H
Suzuya
M
M
Kaneko
T
T
Onishi
H
H
Watanabe
R
R
Nakagawa
Y
Y
Okamoto
N
N
Sano
Y
Y
Kozan
Y
Y
Kuroda
D001706:Biopsy; D002648:Child; D004796:Clinical Enzyme Tests; D019693:Hepatitis, Autoimmune / Q000175:diagnosis / Q000209:etiology* / Q000473:pathology; D006650:Histocompatibility Testing; D006801:Humans; D008297:Male; D036102:Peripheral Blood Stem Cell Transplantation / Q000009:adverse effects*; D054198:Precursor Cell Lymphoblastic Leukemia-Lymphoma / Q000150:complications / Q000628:therapy; D035781:Siblings; D019172:Transplantation Conditioning / Q000009:adverse effects; D014184:Transplantation, Homologous; D014185:Transplantation, Isogeneic