Acute hepatic injury after the withdrawal of immunosuppressive chemotherapy in patients with hepatitis B.
case_report · Level V
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Abstract
Five patients with lymphoproliferative malignancies and chronic hepatitis B suffered severe acute hepatic injury after the withdrawal of multiagent chemotherapy that included high-dose corticosteroid. Four patients died of hepatic failure, three of whom received corticosteroid as treatment for the hepatic injury. We believe that the cause of this entity is massive immune-associated cytolysis of hepatitis B virus infected hepatocytes occurring after a period of immunosuppression and increased viral replication. The literature regarding this complication of chemotherapy and its pathophysiology is reviewed.
Medical subject headings
- Antineoplastic Combined Chemotherapy Protocols
- Hepatitis B
- Hodgkin Disease
- Leukemia, Lymphocytic, Chronic, B-Cell
- Liver
- Lymphoma
- Lymphoma, Non-Hodgkin