title: Acute hepatitis after autologous stem cell transplantation and rapid progression to liver cirrhosis.
abstract: A 51-year-old woman was diagnosed with a diffuse cerebral large cell lymphoma. During the period of a combined chemotherapy followed by autologous stem cell transplantation with multiple blood donations, an acute hepatitis without hepatitis C antibodies was diagnosed. Liver biopsy showed steatohepatitis, initially thought to be related to chemotherapy. Sixteen months after the transplantation, liver cirrhosis appeared with circulatory bypass. Retrospectively, testing of serum samples showed a hepatitis C infection. Infection with the hepatitis C virus (HCV) from a blood donation was excluded through retrospective testing for HCV-RNA of blood donors. Finally, the cause of infection remained elusive. Hepatitis serology is not a reliable test under immunosuppressive therapy. The course of progression to liver cirrhosis in the presented short period of 22 months after HCV infection is remarkable and has - to our knowledge - not been reported in literature before.
authors.affiliation: Division Internal Medicine, District Hospital Clinic Altmühltal, Germany.
authors.forename: Stefan
authors.initials: S
authors.lastname: Zschiedrich
authors.forename: Richard
authors.initials: R
authors.lastname: Fischer
authors.forename: Annette
authors.initials: A
authors.lastname: Schmitt-Gräff
authors.forename: Hubert
authors.initials: H
authors.lastname: Blum
authors.forename: Matthias
authors.initials: M
authors.lastname: Breidert
mesh_terms: D000208:Acute Disease; D001932:Brain Neoplasms / Q000628:therapy*; D018450:Disease Progression; D005260:Female; D006505:Hepatitis / Q000276:immunology / Q000821:virology*; D006526:Hepatitis C / Q000150:complications / Q000276:immunology; D006801:Humans; D016867:Immunocompromised Host; D008103:Liver Cirrhosis / Q000276:immunology / Q000821:virology*; D016403:Lymphoma, Large B-Cell, Diffuse / Q000628:therapy*; D008875:Middle Aged; D033581:Stem Cell Transplantation / Q000009:adverse effects*; D014182:Transplantation, Autologous