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Chronic graft-versus-host disease after hematopoietic cell transplantation presenting as an acute hepatitis

A H Malik1, R H Collins, M H Saboorian

  • 1Department of Internal Medicine, University of Texas Southwestern Medical Center, Dallas 75390-9151, USA.

The American Journal of Gastroenterology
|March 10, 2001
PubMed

A variety of illnesses involving the gut and liver follow hematopoietic cell transplantation (HCT). A 20 yr-old white male developed severe acute hepatitis 36 wk (day 252) after matched, unrelated, allogeneic HCT for chronic myelogenous leukemia (CML). Mild skin graft-versus-host disease (GVHD) had occurred at about 20 wk (day 140) after transplant. Liver biopsy showed bile duct injury and a diffuse lobular injury pattern most consistent with a GVHD variant and not reminiscent of drug-induced or viral hepatitis. No findings suggestive of herpesvirus, adenovirus, or varicella-zoster virus were found. High-dose steroids resulted in marked improvement of his liver enzyme levels. We report this patient as representing the acute hepatitic presentation of chronic GVHD of the liver.

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