Mathews Emily, Laurie Timothy, O'Riordan Kenneth, Nabhan Chadi
Department of Medicine, Advocate Lutheran General Hospital, Park Ridge, Ill., USA.
Case Rep Gastroenterol. 2008 Mar 14;2(1):121-4. doi: 10.1159/000120756.
Liver involvement with acute myeloid leukemia (AML) is rarely reported. The majority of published cases suggest a cholestatic picture and obstructive jaundice at presentation. On the contrary, our patient presented with transaminitis without cholestasis. Elevated liver function tests persisted in our patient despite cholecystectomy; however, they normalized with chemotherapy administration, suggesting that AML was the causative effect of the hepatitis-like picture. Our review of the literature revealed that most reported cases of AML with liver involvement had short-lived remissions and an overall ominous prognosis. In our opinion, patients who have liver involvement with AML should be offered alternative investigational therapies with a low hepatic toxicity profile.
急性髓系白血病(AML)累及肝脏的情况鲜有报道。大多数已发表的病例显示,发病时呈现胆汁淤积和梗阻性黄疸的症状。相反,我们的患者表现为转氨酶升高但无胆汁淤积。尽管进行了胆囊切除术,我们患者的肝功能检查结果仍持续异常;然而,化疗后肝功能恢复正常,这表明AML是类似肝炎症状的病因。我们对文献的回顾发现,大多数报道的AML累及肝脏的病例缓解期短暂,总体预后不佳。我们认为,对于AML累及肝脏的患者,应提供肝毒性较低的替代研究性治疗方法。