Management of giant cell hepatitis associated with chronic lymphocytic leukemia - A case series and review of the literature Journal Article
| Authors: | Rhodes, J. M.; Schuster, S. J.; Furth, E. E.; Kennard, K.; Nasta, S. D.; Svoboda, J.; Porter, D. L.; Mato, A. R. |
| Article Title: | Management of giant cell hepatitis associated with chronic lymphocytic leukemia - A case series and review of the literature |
| Abstract: | Giant cell hepatitis (GCH) is a rare diagnosis in adults that is found in 0.25% of liver biopsies. GCH has been associated with multiple causes including drugs (6-mercaptopurine, methotrexate), toxins, viruses and autoimmune. GCH has been described in few patients with chronic lymphocytic leukemia (CLL). Here we describe three patients diagnosed with GCH thought to be related to underlying CLL and its management. All of our patients were treated with a combination of immunosuppression as well as CLL-directed therapy to address CLL and concomitant liver disease. GCH is a rare manifestation of active CLL and should be ruled out with prompt liver biopsy in patients with CLL with persistent transaminitis without another attributable cause. Prompt treatment of GCH with immunosuppression is required to prevent long-term liver toxicity. If transaminitis does not improve with immunosuppression alone, the addition of CLL directed therapy should be considered in patients who carry this diagnosis to prevent long-term liver toxicity. © 2019, © 2019 Taylor & Francis Group, LLC. |
| Keywords: | adult; cancer chemotherapy; clinical article; human tissue; aged; middle aged; prednisone; drug tolerability; case report; hepatitis; cancer combination chemotherapy; drug dose reduction; drug withdrawal; liver cirrhosis; liver function; side effect; methotrexate; rituximab; laparoscopy; disease association; computer assisted tomography; multiple cycle treatment; bendamustine; cyclophosphamide; immunoglobulin; b lymphocyte; alanine aminotransferase; aspartate aminotransferase; bilirubin; cd20 antigen; add on therapy; hepatomegaly; antinuclear antibody; lactate dehydrogenase; azathioprine; autoimmune hemolytic anemia; rheumatoid arthritis; liver cell; lymphocytic infiltration; disease control; drug dose increase; immunosuppressive treatment; liver hilus; erythrocyte transfusion; chronic lymphatic leukemia; immunoglobulin deficiency; cd5 antigen; liver biopsy; hydroxymethylglutaryl coenzyme a reductase inhibitor; giant cell; lymphadenopathy; liver injury; cholestasis; case study; erythrophagocytosis; steroid therapy; chronic lymphocytic leukemia; autoimmune hepatitis; hypertransaminasemia; cd23 antigen; ofatumumab; lymphocytosis; liver fibrosis; transaminitis; maintenance chemotherapy; mesentery lymph node; ibrutinib; human; male; female; article; malignant ascites; positron emission tomography-computed tomography; giant cell hepatitis |
| Journal Title: | Cancer Biology and Therapy |
| Volume: | 20 |
| Issue: | 8 |
| ISSN: | 1538-4047 |
| Publisher: | Taylor & Francis Group |
| Date Published: | 2019-01-01 |
| Start Page: | 1136 |
| End Page: | 1140 |
| Language: | English |
| DOI: | 10.1080/15384047.2019.1598763 |
| PUBMED: | 31091174 |
| PROVIDER: | scopus |
| PMCID: | PMC6628867 |
| DOI/URL: | |
| Notes: | Article -- Source: Scopus |
