Hodgkin’s lymphoma as a rare cause of vanishing bile duct syndrome: a case report

Sunger, Erdem; Yorulmaz, Elif; Atay, Ahmet Engin; Karadeniz, Burcak; Paşaoğlu, Hüsniye Esra; Kaymakoğlu, Sabahattin; İliaz, Raim

doi:10.5350/bmb20180730075415

Cited by 1 publication

(4 citation statements)

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“…VBDS is characterized by the disappearance of bile ducts, with the progressive damage resulting in cholestasis. 3 Prior evidence implies on the state of disease progression, which ultimately leads to hepatic failure. Earlier, patients with HL-related VBDS have been reported to have poor prognosis and overall survival.…”

Section: Discussionmentioning

confidence: 99%

“…It has been reported that levels of bilirubin are reliable laboratory markers when compared with ALP, in the evaluation of response to treatment. 3 Ebadi et al's 21 study shows that, along with curative chemotherapy, tumor-directed radiotherapy, when used as a bridge in HL-associated VBDS (for lesions above the diaphragm), results in an improvement of liver function. However, the authors 21 could not measure the amount of tumor cytoreduction necessary to diminish the paraneoplastic liver damage and in turn permit the regeneration of the bile duct.…”

Section: Discussionmentioning

confidence: 99%

“…It has been reported that levels of bilirubin are reliable laboratory markers when compared with ALP, in the evaluation of response to treatment. 3…”

Section: Discussionmentioning

confidence: 99%

“…1,2 The loss of interlobular bile ducts in at least 50% of the small portal tracts is called ductopenia. 3 The pathogenesis of VBDS is uncertain. 2 Drugs such as ibuprofen, allopurinol, ampicillin, amoxicillin-clavulinic acid, erythromycin, and meropenem have been accused of causing VBDS secondary to cholestasis.…”

Section: Introductionmentioning

confidence: 99%

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A rare presentation of vanishing bile duct syndrome in Hodgkin lymphoma: Case report

Patodiya,

Ramani,

Rao

et al. 2023

SAGE Open Medical Case Reports

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In this report, we present the case of vanishing bile duct syndrome in the setting of classical Hodgkin lymphoma. Vanishing bile duct syndrome was diagnosed retrospectively in this patient with Hodgkin lymphoma, who initially presented with a hepatic abnormality presumed to be drug induced. Vanishing bile duct syndrome is characterized by the disappearance of bile ducts, with the progressive damage resulting in cholestasis. Thus, nivolumab therapy was initiated for Hodgkin lymphoma, in place of the standard ABVD (Doxorubicin, bleomycin, vinblastine, dacarbazine) regimen, which resulted in autoimmune hemolytic anemia. Alternatively, GDP (gemcitabine, dexamethasone, and carboplatin) chemotherapy with protocol modification resulted in better tolerance and remission of Hodgkin lymphoma. Granulocyte colony-stimulating factor support and romiplostim supplement were provided to prevent chemotherapy-induced neutropenia and thrombocytopenia, respectively. Due to the deranged liver function in our case, we initially suspected the etiology as drug-induced cholestatic injury. While hepatic failure is the leading cause of mortality among patients with Hodgkin lymphoma-related vanishing bile duct syndrome, our case report suggests a complete remission of vanishing bile duct syndrome following an adequate treatment of Hodgkin lymphoma and an improvement in the hepatic function. To conclude, our report describes the rare case of vanishing bile duct syndrome which heralded the diagnosis of Hodgkin lymphoma, and the effective management of Hodgkin lymphoma which precedes the improvement of hepatic abnormality.

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Section: Discussionmentioning

confidence: 99%

Section: Discussionmentioning

confidence: 99%

“…It has been reported that levels of bilirubin are reliable laboratory markers when compared with ALP, in the evaluation of response to treatment. 3…”

Section: Discussionmentioning

confidence: 99%