Case ReportDeeper Insights Into Vanishing Bile Duct Syndrome in Lymphoma: A Perplexing Entity
Section snippets
Case Report
A 39-year-old man presented to the emergency department in July 2013 with a 6-month history of intermittent fever, fatigue, weight loss of 30 lb, and drenching night sweats. He had been evaluated at various hospitals for fever of unknown origin. He also reported a new onset of jaundice that had developing during the 2 weeks before admission. He denied any potentially hepatotoxic medications, recent or chronic alcohol intake, illicit intravenous drug use, or any family history of liver disease.
Discussion
Lymphomas, including both HL and non-HL (NHL), can cause hepatic dysfunction, ranging from asymptomatic elevation of liver enzymes to fulminant liver failure.1, 2 Hepatic involvement can be seen in 20% of liver biopsy specimens and 50% of necropsies in patients with NHL. The frequency of hepatic involvement in HL can vary. Liver infiltration in Hodgkin disease has been observed in 5% to 8% of cases, and in autopsy series, the range has been as high as 30% to 70%. Cholestasis as the presenting
Conclusion
Although previous case series have reported that VBDS in lymphoma carries a dismal prognosis, early treatment with appropriate chemotherapeutic agents with subsequent use of standard of care therapies for HL and NHL after hepatic dysfunction may improve patient outcomes.
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