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Acute liver failure due to hepatic involvement by hematologic malignancy
T M Shehab1, M S Kaminski, A S Lok
1Department of Internal Medicine, University of Michigan Medical Center, Ann Arbor, USA.
Digestive Diseases and Sciences
|July 1, 1997
Summary
Richter's transformation, a complication of chronic lymphocytic leukemia, can rarely cause acute liver failure. This case highlights successful chemotherapy treatment for this rare presentation of high-grade lymphoma.
Area of Science:
- Hematology
- Oncology
- Hepatology
Background:
- Malignant infiltration of the liver is a rare cause of acute liver failure, often with a fatal prognosis.
- Richter's transformation (RT) signifies the progression of chronic lymphocytic leukemia (CLL) to aggressive lymphoma.
Observation:
- A 64-year-old male with a history of CLL presented with acute liver failure.
- Liver biopsy confirmed hepatic infiltration by high-grade lymphoma, indicative of RT.
Findings:
- The patient's acute liver failure was attributed to hepatic involvement by RT.
- Chemotherapy led to normalization of liver function and sustained disease remission for eight months.
Implications:
- This case is the first documented instance of RT presenting as acute liver failure.
- It underscores the importance of considering hematopoietic malignancies in unexplained acute liver failure and demonstrates a treatable pathway.