Before it crumbles: Fulminant Hepatic Failure secondary to Hodgkin's Lymphoma

Karmacharya, Paras; Bhandari, Naresh; Aryal, Madan Raj; Pandit, Aashrayata A.; Pathak, Ranjan; Ghimire, Sailu; Shrestha, Pragya; Bhatt, Vijaya Raj

doi:10.3402/jchimp.v4.25821

Cited by 12 publications

(7 citation statements)

References 11 publications

(29 reference statements)

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“…Karmacharya ve ark. nın [3] yayınlamı oldu¤u bir olgu sunumunda Hodgkin lenfomanın FHY'ye neden olması-na ilikin birkaç mekanizmadan bahsedilmitir. Karaci¤er disfonksiyonu öncelikle karaci¤er parankimi, safra yolları ve karaci¤er vasküler sisteminin lenfoma hücrelerince infiltrasyonuna ba¤lı olutu¤u düünülmektedir.…”

Section: Tartimaunclassified

Fulminant hepatic failure presented with Hodgkin lymphoma

Akarken¹

2017

FNG & Bilim Tıp Dergisi

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Fulminant hepatic disease has an aggressive nature with a high mortality rate. Viral hepatitis is in the first place among its causes. Other than this, liver failure may rarely occur in lymphoma patients. The prevalence of liver failure in Hodgkin's lymphoma is lower than that of non-Hodgkin's lymphoma. In this report, we present a 44-year-old male patient with liver failure who was diagnosed as Hodgkin lymphoma during the postmortem examination. Fulminan hepatik yetmezlik (FHY), akut karaci¤er yetmezli¤i olarak da adlandırılır. Seyrek görülmesinin yanı sıra agresif seyirli ve kötü prognozlu bir hastalıktır. Sarılık balangıcını takiben hepatik ensefalopatinin ortaya çıkma süresine göre sınıflandırılır. Bir haftadan az bir sürede geliiyorsa "hiperakut", 8-28 gün arasında ise "akut", 5-12 hafta arasında ise "subakut" karaci¤er yetmezli¤i terimleri kullanılır.[1] Etyolojide ön planda viral ve toksik hepatitler olmasına karın nadiren lenfoma ve lösemilere sekonder de geliebilir. Bu yazıda nedeni bilinmeyen ate ile takip edilirken akut karaci¤er yetmezli¤i gelien ve hodgkin lenfoma tanısı konulan bir erkek hasta sunuldu. OLGU SUNUMUKuyumculuk ile u¤raan ve son 1.5 aydır devam eden ate, üüme, titreme yakınması ile dahiliye poliklini¤ine bavuran 44 yaındaki erkek hastanın öyküsünden, herhangi bir kronik hastalı¤ı ve ilaç kullanım öyküsü olmadı¤ı, bir yıl önce menengiom nedeniyle ameliyat oldu¤u, beyin parankiminin normal oldu¤u ve invazyonu olmadı¤ı ö¤renildi. ‹leri derecede halsizlik, itahsızlık ve yaklaık 4-5 kg/ay kilo kaybı vardı. Hayvanlarla veya la¤ım ile temas öyküsü yoktu. Pastörize edilmemi süt ürünü kullanmıyordu. Fizik muayenesinde; tansiyon ve nabız normaldi. Ate gün içinde en yüksek 38.5 °C ölçüldü. Cildi sarı ve nemli görünümde idi ve sistemik lenf nodu muayenesinde ele gelen lenf nodu yoktu. Batın muayenesinde; karaci¤er kaburga altında 2 cm palpe ediliyordu. Bilinci açık, oryantasyon, kooperasyon ve di¤er sistem muayeneleri ola¤andı. Laboratuvar de¤erlerinde; Açlık glukoz: 116 mg/dL, üre: 46 mg/dL, kreatinin: 1.2 mg/dL, AST: 236 U/L, ALT: 91U/L, Na: 126 mmol/L, total bilirubin: 4.3 mg/dL, direct bilirubin: 2.6 mg/dL, hemoglobin: 9.2 gr/dL,

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Section: Tartimaunclassified

Fulminant hepatic failure presented with Hodgkin lymphoma

Akarken¹

2017

FNG & Bilim Tıp Dergisi

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“…Fulminant hepatic failure is defined as an acute onset of liver disease compromising the liver's synthetic function. Typical findings include hepatic encephalopathy and prolongation of the INR (>1.5) which occur within an 8 week time frame [1,2]. The most common precipitators of acute hepatic failure include viral hepatitis, medications, drugs, and toxins with less common causes including metabolic disorders and vascular disorders such as hepatic vein thrombosis [2][3][4].…”

Section: Introductionmentioning

confidence: 99%

“…Typical findings include hepatic encephalopathy and prolongation of the INR (>1.5) which occur within an 8 week time frame [1,2]. The most common precipitators of acute hepatic failure include viral hepatitis, medications, drugs, and toxins with less common causes including metabolic disorders and vascular disorders such as hepatic vein thrombosis [2][3][4]. Rarely is malignancy the presenting feature of liver dysfunction, but when the presentation does arise, the malignancy is typically advanced in stage, and not of hepatic origin [1][2][3][4].…”

Section: Introductionmentioning

confidence: 99%

“…The most common precipitators of acute hepatic failure include viral hepatitis, medications, drugs, and toxins with less common causes including metabolic disorders and vascular disorders such as hepatic vein thrombosis [2][3][4]. Rarely is malignancy the presenting feature of liver dysfunction, but when the presentation does arise, the malignancy is typically advanced in stage, and not of hepatic origin [1][2][3][4]. This is significant as a history of malignancy precludes the patient from receiving a liver transplant [5], and if not addressed in a time, hepatic dysfunction may progress to hepatic failure.…”

Section: Introductionmentioning

confidence: 99%

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Hepatic Dysfunction as Presenting Manifestation of Hodgkin’s lymphoma

Df¹,

Rs²,

Hall³

et al. 2016

Journal of Gastroenterology and Its Complications

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“…This liver malignanat involvement can induce fulminant hepatic failure (if the diagnosis is not made early), which is a containdication for chemotherapy. The prognostic of such patients is very poor [27]. Such a liver failure initial presentation was found in an explanted liver from a patient with clinical diagnosed alcoholic cirrhosis.…”

mentioning

confidence: 99%

Liver Involvement in Hodgkin's Lymphoma: Types of Injuries and Therapeutic Implications

Mihăilă

2017

IJPPE

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Abstract. The hepatocytolysis raises questions on following therapeutic conduct when it occurs during chemotherapy for Hodgkin's lymphoma, expression of its liver toxicity. But the onset of primary liver Hodgkin's lymphoma, including the form manifested by acute liver failure, poses even greater problems, as in the case of occurrence of vanishing bile duct syndrome -expression of a paraneoplastic syndrome, hemophagocytic lymphohistiocytosis, peliosis hepatis or association of lymphoma with infection with hepatitis viruses or human immunodeficiency virus or different autoimmune diseases. This review summarizes the clinical experience acquired on the relationship between Hodgkin's lymphoma and liver, from the point of view of clinical manifestations, used treatments and clinical evolution. Suggestions on the course of treatment in patients with Hodgkin's lymphoma and liver damage have been formulated starting from the metabolism and elimination of chemotherapy drugs and taking into account the clinical experience of published clinical trials and cases. This review is a synthesis of knowledge obtained in this field, during the time, of therapeutic possibilities and limits, and formulates potential future milestones for research.

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Before it crumbles: Fulminant Hepatic Failure secondary to Hodgkin's Lymphoma

Cited by 12 publications

References 11 publications

Fulminant hepatic failure presented with Hodgkin lymphoma

Fulminant hepatic failure presented with Hodgkin lymphoma

Hepatic Dysfunction as Presenting Manifestation of Hodgkin’s lymphoma

Liver Involvement in Hodgkin's Lymphoma: Types of Injuries and Therapeutic Implications

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