PriMera Scientific Surgical Research and Practice (ISSN: 2836-0028)

Case Study

Volume 2 Issue 4

Severe Jaundice, due to Vanishing Bile Duct Syndrome in Hodgkin's Lymphoma, Fully Reversible after Chemotherapy

Pramod Kumar Singh*, Rajit Rattan, Ritesh Kumar and Budhi Singh Yadav

September 26, 2023

DOI : 10.56831/PSSRP-02-062

View PDF

Abstract

Liver involvement in Hodgkin's lymphoma is common and is caused by hepatic infiltration, biliary obstruction by lymphoma, hepatitis, sepsis or complications of chemotherapeutic treatment. Jaundice caused by the vanishing bile duct syndrome related to Hodgkin's lymphoma is very rare. The mechanism is poorly understood but a paraneoplastic effect seems most likely as liver biopsy and imaging study the absence of lymphoma cells in liver. We describe a 13-year-old man with vanishing bile duct syndrome and Hodgkin's lymphoma who was treated successfully with chemotherapy. The markedly elevated serum Bilirubin levels completely normalized. Our case demonstrates that although dosing of chemotherapy in this situation can be very difficult, a good clinical outcome is possible, which makes the attempt at curative treatment worthwhile.

Keywords: Hodgkin’s lymphoma; jaundice; vanishing bile duct

References

  1. Abe H, Kubota K and Makuuchi M. “Obstructive jaundice secondary to Hodgkin’s disease”. Am J. Gastroenterol 92 (1996): 526-7.
  2. Yalcin S., et al. “Extrahepatic Hodgkin’s disease with intrahepatic cholestasis: report of two cases”. Oncology 57 (1999): 83-5.
  3. Liangpunsakul S, Kwo P and Koukoulis GK. “Hodgkin’s disease presenting as cholestatic hepatitis with prominent ductal injury”. Eur J. Gastroenterol Hepatol 14 (2002): 323-7.
  4. Gupta A, Roebuck DJ and Michalski AJ. “Biliary involvement in Hodgkin’s disease”. Pediatr Radiol 32 (2002): 202-4.
  5. Barbado FJ., et al. “Fever of unknown origin: a survey on 133 patients”. J. Med 15 (1984): 185-92.
  6. Cervantes F., et al. “Hodgkin’s disease presenting as a cholestatic febrile illness: incidence and main characteristics in a series of 421 patients”. Ann Hematol 72 (1996): 357-60.
  7. Bouroncle BA, Old JW Jr and Vazques AG. “Pathogenesis of jaundice in Hodgkin’s disease”. Arch Intern Med 110 (1962): 872-883.
  8. Birrer MJ and Young RC. “Differential diagnosis of jaundice in lymphoma patients”. Semin Liver Dis 7 (1987): 269-277.
  9. Bagley CM Jr., et al. “Diagnosis of liver involvement by lymphoma: results in 96 consecutive peritoneoscopies”. Cancer 31 (1973): 840-847.
  10. Han WS., et al. “Spontaneous resolution of vanishing bile duct syndrome in Hodgkin’s lymphoma”. Korean J Hepatol 11 (2005): 164-168.
  11. Cordoba IA., et al. “Ductal regeneration in vanishing bile duct syndrome in Hodgkin’s lymphoma”. Gastroenterol Hepatol 28 (2005): 275-278.
  12. Guliter S., et al. “Cholestatic liver disease with ductopenia (vanishing bile duct syndrome) in Hodgkin’s disease: report of a case”. Tumori 90 (2004): 517-520.
  13. Ripoll C., et al. “Idiopathic cholestasis associated with progressive ductopenia in two patients with Hodgkin’s disease”. Gastroenterol Hepatol 25 (2002): 313-315.
  14. Allory Y, Metreau J and Zafrani E. “Paraneoplastic vanishing bile duct syndrome in a case of Hodgkin’s disease”. Ann Pathol 20 (2000): 52-55.
  15. Hubscher SG, Lumley MA and Elias E. “Vanishing bile duct syndrome: a possible mechanism for intrahepatic cholestasis in Hodgkin’s lymphoma”. Hepatology 17 (1993): 70-77.
  16. Rossini MS., et al. “Vanishing bile duct syndrome in Hodgkin’s disease: case report”. Sao Paulo Med J 118 (2000): 154-157.
  17. Sherlock S. “Overview of chronic cholestatic conditions in adults: terminology and definitions”. Clin Liver Dis 2 (1998): 217-233.
  18. Kikuchi K., et al. “Vanishing bile duct syndrome associated with chronic EBV infection”. Dig Dis Sci 45 (2000): 160-165.
  19. Gottrand F., et al. “Intrahepatic cholestasis related to vanishing bile duct syndrome in Hodgkin’s disease”. J Pediatr Gastroenterol Nutr 24 (1997): 430-433.
  20. Yusuf MA, Elias E and Hubscher SG. “Jaundice caused by the vanishing bile duct syndrome in a child with Hodgkin lymphoma”. J Pediatr Hematol Oncol 22 (2000): 154-157.
  21. Crosbie OM., et al. “Resolution of paraneoplastic bile duct paucity following successful treatment of Hodgkin’s disease”. Hepatology 26 (1997): 5-8.
  22. Liangpunsakul S, Kwo P and Koukoulis GK. “Hodgkin’s disease presenting as cholestatic hepatitis with prominent ductal injury”. Eur J Gastroenterol Hepatol 14 (2002): 323-327.