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Vanishing bile duct syndrome in a Hodgkin's lymphoma patient with fatal outcome despite lymphoma remission
Saudi Journal of Gastroenterology [The]. 2013; 19 (6): 286-289
in English | IMEMR | ID: emr-143010
ABSTRACT
Vanishing bile duct syndrome [VBDS] is a condition resulting from severe bile duct injury, progressive destruction, and disappearance of intrahepatic bile ducts [ductopenia] leading to cholestasis, biliary cirrhosis, and liver failure. VBDS can be associated with a variety of disorders, including Hodgkin's lymphoma [HL]. We describe a 33-year-old male patient who presented with lymphadenopathy and jaundice, and was diagnosed to have HL. Serum bilirubin worsened progressively despite chemotherapy, with a cholestatic pattern of liver enzymes. Diagnosis of VBDS was established on liver biopsy. Although remission from HL was achieved, the patient died of liver failure. Presence of jaundice in HL patients should raise the possibility of VBDS. This report discusses the difficulties of delivering chemotherapy in patients with liver dysfunction. HL-associated VBDS carries a high mortality but lymphoma remission can be achieved in some patients. Therefore, liver transplantation should be considered early in these patients.
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Index: IMEMR (Eastern Mediterranean) Main subject: Bile Duct Diseases / Hodgkin Disease / Antineoplastic Combined Chemotherapy Protocols / Cholestasis / Fatal Outcome / Hyperbilirubinemia Type of study: Case report Limits: Humans / Male Language: English Journal: Saudi J. Gastroenterol. Year: 2013

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Index: IMEMR (Eastern Mediterranean) Main subject: Bile Duct Diseases / Hodgkin Disease / Antineoplastic Combined Chemotherapy Protocols / Cholestasis / Fatal Outcome / Hyperbilirubinemia Type of study: Case report Limits: Humans / Male Language: English Journal: Saudi J. Gastroenterol. Year: 2013