Hepatic graft-versus-host disease presenting as an acute hepatitis after allogeneic peripheral blood stem cell transplantation

N. Fujii, Katsuto Takenaka, K. Shinagawa, K. Ikeda, Y. Maeda, K. Sunami, Y. Hiramatsu, K. Matsuo, F. Ishimaru, K. Niiya, T. Yoshino, N. Hirabayashi, M. Harada

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Abstract

Hepatic graft-versus-host disease (GVHD) generally presents as cholestatic jaundice, and increased serum alkaline phosphatase (ALP) is followed by hyperbilirubinemia and clinical jaundice. Currently accepted standards for evaluating the clinical severity of GVHD are based not on serum aminotransferase levels but on the serum bilirubin level. We describe a 17-year-old Japanese female who had increased aminotransferases without cholestasis on day 23 after allogeneic peripheral blood stem cell transplantation (allo-PBSCT). Liver biopsy revealed lymphocytic infiltration of the portal tracts and pericentral necrosis of the lobuli. The limiting plates were not clearly defined due to cellular infiltrates. There was periductal lymphocytic infiltration and vacuolization of the biliary epithelial cells with exocytosis, compatible with GVHD of cholangiohepatitic type. These findings indicate that acute hepatic GVHD may present as acute hepatitis and this should be included in the differential diagnosis for patients with increased aminotransferases after allogeneic stem cell transplantation.

Original languageEnglish
Pages (from-to)1007-1010
Number of pages4
JournalBone Marrow Transplantation
Volume27
Issue number9
DOIs
Publication statusPublished - Jun 23 2001

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Peripheral Blood Stem Cell Transplantation
Graft vs Host Disease
Hepatitis
Transaminases
Liver
Serum
Hyperbilirubinemia
Obstructive Jaundice
Cholestasis
Exocytosis
Stem Cell Transplantation
Jaundice
Bilirubin
Alkaline Phosphatase
Differential Diagnosis
Necrosis
Epithelial Cells
Biopsy

All Science Journal Classification (ASJC) codes

  • Hematology
  • Transplantation

Cite this

Hepatic graft-versus-host disease presenting as an acute hepatitis after allogeneic peripheral blood stem cell transplantation. / Fujii, N.; Takenaka, Katsuto; Shinagawa, K.; Ikeda, K.; Maeda, Y.; Sunami, K.; Hiramatsu, Y.; Matsuo, K.; Ishimaru, F.; Niiya, K.; Yoshino, T.; Hirabayashi, N.; Harada, M.

In: Bone Marrow Transplantation, Vol. 27, No. 9, 23.06.2001, p. 1007-1010.

Research output: Contribution to journalArticle

Fujii, N, Takenaka, K, Shinagawa, K, Ikeda, K, Maeda, Y, Sunami, K, Hiramatsu, Y, Matsuo, K, Ishimaru, F, Niiya, K, Yoshino, T, Hirabayashi, N & Harada, M 2001, 'Hepatic graft-versus-host disease presenting as an acute hepatitis after allogeneic peripheral blood stem cell transplantation', Bone Marrow Transplantation, vol. 27, no. 9, pp. 1007-1010. https://doi.org/10.1038/sj.bmt.1702997
Fujii, N. ; Takenaka, Katsuto ; Shinagawa, K. ; Ikeda, K. ; Maeda, Y. ; Sunami, K. ; Hiramatsu, Y. ; Matsuo, K. ; Ishimaru, F. ; Niiya, K. ; Yoshino, T. ; Hirabayashi, N. ; Harada, M. / Hepatic graft-versus-host disease presenting as an acute hepatitis after allogeneic peripheral blood stem cell transplantation. In: Bone Marrow Transplantation. 2001 ; Vol. 27, No. 9. pp. 1007-1010.
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