Email updates

Keep up to date with the latest news and content from BMC Hematology and BioMed Central.

Open Access Case report

Syncytial giant cell hepatitis associated with chronic lymphocytic leukemia: a case report

Eva Gupta1, Michael Yacoub1, Martha Higgins2 and Ayad M Al-Katib13*

Author Affiliations

1 Department of Medicine, St John Hospital and Medical Center, Detroit, MI, 48236, USA

2 Department of Pathology, St John Hospital and Medical Center, Detroit, MI, 48236, USA

3 Van Elslander Cancer Center, St John Hospital and Medical Center, 19229 Mack Avenue, Suite #36, Grosse Pointe Woods, MI, 48236, USA

For all author emails, please log on.

BMC Blood Disorders 2012, 12:8  doi:10.1186/1471-2326-12-8

Published: 19 July 2012

Abstract

Background

Syncytial giant cell hepatitis (GCH) is an uncommon and an underreported disease entity. In two previously reported cases of GCH in patients with Chronic Lymphocytic Leukemia (CLL) liver failure ensued. Autoimmune and infective causes have been implicated but its etiology remains unclear.

Case Presentation

A 60-year-old female with CLL presented with acute hepatitis with negative viral and auto-immune serologies and without any prior toxic exposure. Liver biopsy showed typical histological features of GCH. The patient was successfully treated with corticosteroids and intravenous immunoglobulin (IVIG). Her liver enzymes returned to baseline and have remained normal as of the last follow up almost 4 years later.

Conclusions

Association of GCH with CLL may be under recognized. Clinical suspicion of GCH in CLL patients with serology-negative hepatitis, early liver biopsy and therapeutic intervention may influence outcome. This is the first case report of successful treatment of GCH in CLL patients. Moreover, our case also demonstrates the ability to resume effective CLL therapy post-GCH diagnosis without detriment to the liver.