Atypical presentation of 'acalculous cholecystitis' with marked isolated hyperbilirubinaemia in patients treated for haematological malignancies.
Four patients diagnosed with haematological malignancies developed an isolated hyperbilirubinaemia following cytarabine- and anthracycline-based chemotherapy. The clinical picture was consistent with acalculous cholecystitis, but ultrasonography did not show the typical gallbladder wall thickening. All patients suffered from severe mucositis with neutropenic enterocolitis. We hypothesise that damage of the mucosa of the gallbladder induced by chemotherapy results in hyperpermeability of the mucosal barrier with bile leakage and isolated hyperbilirubinaemia.
Department of Haematology, RadboudUMC, Nijmegen, the Netherlands.
Marvin A H
MA
Berrevoets
John J
JJ
Hermans
Geert J A
GJ
Wanten
Walter J F M
WJ
van der Velden
D042101:Acalculous Cholecystitis / Q000175:diagnosis* / Q000188:drug therapy / Q000209:etiology*; D000890:Anti-Infective Agents / Q000627:therapeutic use; D000971:Antineoplastic Combined Chemotherapy Protocols / Q000009:adverse effects / Q000627:therapeutic use; D005260:Female; D019337:Hematologic Neoplasms / Q000150:complications* / Q000188:drug therapy; D006801:Humans; D006932:Hyperbilirubinemia / Q000209:etiology*; D008111:Liver Function Tests; D008297:Male; D008875:Middle Aged; D016896:Treatment Outcome
D000890:Anti-Infective Agents
acalculous cholecystitis; acute myeloid leukaemia; chemotherapy; hyperbilirubinaemia; myelodysplastic syndrome