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Abstract
BackgroundSyncytial 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 PresentationA 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.ConclusionsAssociation 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.
Highlights
Syncytial giant cell hepatitis (GCH) is an uncommon and an underreported disease entity
We describe a patient with chronic lymphocytic leukemia (CLL) who developed GCH and was successfully treated with
In conclusion, our case brings to attention the association between CLL and GCH
Summary
Our case brings to attention the association between CLL and GCH. High index of suspicion is required in serology-negative acute hepatitis in patients with CLL. While there is no evidence to date demonstrating increased risk of CLL patients to GCH, the host environment in CLL is conducive of GCH, i.e. association with auto antibodies and susceptibility to infections. Recognizing such cases is crucial to the development of suitable therapeutic strategies. Competing interests The authors of this manuscript declare that they have no competing interests. All authors contributed towards the preparation of this manuscript. All authors read and approved the final manuscript
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