title: Hodgkin's lymphoma coexisting with liver failure secondary to acute on chronic hepatitis B.
abstract: Acute on chronic liver failure (ACLF) is rarely the initial manifestation of a malignant process or precipitated by the initiation of anti-viral treatment with a nucleoside or nucleotide agent. We report an unusual case of ACLF temporally associated with initiation of Entecavir for treatment of chronic hepatitis B. Early Hodgkin's lymphoma (HL) was unmasked with initiation of the anti-viral treatment which may have exacerbated ACLF. To the best of our knowledge, this has not been described in the literature. In reviewing our patients clinical course and liver autopsy, he developed a severe acute exacerbation of his chronic hepatitis B virus coinciding with the institution of antiviral therapy and the underlying HL perhaps modulating the overall degree of hepatic injury.
authors.affiliation: Renee Palta, Karl Esrason, Division of Gastrointestinal and Liver Disease, Department of Transplant Hepatology, Kaiser Permanente Los Angeles Medical Center, Los Angeles, CA 90027, United States.
authors.forename: Renee
authors.initials: R
authors.lastname: Palta
authors.forename: Amy
authors.initials: A
authors.lastname: McClune
authors.forename: Karl
authors.initials: K
authors.lastname: Esrason
keywords: Acute liver failure; Chronic hepatitis; Entecavir; Fulminant hepatic failure; Hepatic flare; Hodgkin’s lymphoma