Hodgkin's disease with hyperferritinemia, hepatic and heart failure

ABSTRACT

Diffuse hepatic infiltration is an unusual form of Hodgkin's disease [HD]. Its manifestation as progressive hepatitis or with hepatic failure is even rarer and can be difficult to diagnose. We aim to describe an unusual case of liver failure due to HD. A middle-aged woman with a 10 month history of daily febrile episodes, constitutional symptoms and strikingly high levels of serum ferritin was admitted to our hospital with pancytopenia and jaundice. The patient rapidly deteriorated, and developed hepatic and heart failure. A liver biopsy revealed infiltration of the liver with mixed cellularity type HD that was confirmed by lymph node biopsy. HD must be considered in the differential diagnosis of obstructive jaundice in adults. Liver biopsy early in the course of liver dysfunction may establish this diagnosis without a higher risk of bleeding complications seen once liver failure sets in