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Hepatic Dysfunction in a Child Post Bone Marrow Transplantation.

Vikrant Sood1, Juhi Chawla2, Bikrant B Lal1

  • 1Department of Pediatric Hepatology, Institute of Liver and Biliary Sciences, D-1, Vasant Kunj, New Delhi, India.

Journal of Clinical and Experimental Hepatology
|October 11, 2018
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Summary

A pediatric bone marrow transplant patient with Hepatitis C Viral (HCV) infection developed liver dysfunction and skin rash. This was attributed to HCV-related liver injury and chronic graft-versus-host disease.

Keywords:
ALT, Alanine AminotransferaseAST, Aspartate AminotransferaseBMT, Bone Marrow TransplantationDAA, Direct-Acting AntiviralDILI, Drug Induced Liver InjuryGVHD, Graft Versus Host DiseaseHAI, Hepatic Activity IndexHCV, Hepatitis C VirusMRI, Magnetic Resonance ImagingRNA, Ribonucleic Acidbone marrow transplantationgraft versus host diseasepediatric hepatitis C infection

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Area of Science:

  • Hematology
  • Hepatology
  • Immunology

Background:

  • Beta-Thalassemia major requires bone marrow transplantation for treatment.
  • Hepatitis C Viral (HCV) infection poses a significant comorbidity.
  • Bone marrow transplantation can lead to complex post-transplant complications.

Purpose of the Study:

  • To investigate the etiology of hepatic dysfunction and skin rash in a pediatric bone marrow transplant recipient.
  • To differentiate between transplant-related complications and pre-existing comorbidities.
  • To highlight the diagnostic challenges in post-transplant management.

Main Methods:

  • Clinical case presentation and patient history review.
  • Evaluation of hepatic functions and dermatological examination.
  • Diagnostic workup for infectious and immunological complications.

Main Results:

  • The patient presented with worsening hepatic functions and a skin rash 7 months post-transplant.
  • Hepatic dysfunction was confirmed to be secondary to HCV-related hepatic injury.
  • Concomitant chronic graft-versus-host disease with dermatological involvement was diagnosed.

Conclusions:

  • Hepatitis C Viral (HCV) infection can exacerbate hepatic injury post-bone marrow transplantation.
  • Chronic graft-versus-host disease can manifest with dermatological symptoms in transplant recipients.
  • Multidisciplinary evaluation is crucial for managing complex post-transplant complications.