Palta Renee, McClune Amy, Esrason Karl
Renee Palta, Karl Esrason, Division of Gastrointestinal and Liver Disease, Department of Transplant Hepatology, Kaiser Permanente Los Angeles Medical Center, Los Angeles, CA 90027, United States.
World J Clin Cases. 2013 Apr 16;1(1):37-40. doi: 10.12998/wjcc.v1.i1.37.
Acute on chronic liver failure (ACLF) is rarely the initial manifestation of a malignant process or precipitated by the initiation of anti-viral treatment with a nucleoside or nucleotide agent. We report an unusual case of ACLF temporally associated with initiation of Entecavir for treatment of chronic hepatitis B. Early Hodgkin's lymphoma (HL) was unmasked with initiation of the anti-viral treatment which may have exacerbated ACLF. To the best of our knowledge, this has not been described in the literature. In reviewing our patients clinical course and liver autopsy, he developed a severe acute exacerbation of his chronic hepatitis B virus coinciding with the institution of antiviral therapy and the underlying HL perhaps modulating the overall degree of hepatic injury.
慢加急性肝衰竭(ACLF)很少是恶性疾病的初始表现,也很少由核苷或核苷酸类抗病毒治疗引发。我们报告了一例不寻常的ACLF病例,其在时间上与开始使用恩替卡韦治疗慢性乙型肝炎相关。抗病毒治疗开始后,早期霍奇金淋巴瘤(HL)被发现,这可能加重了ACLF。据我们所知,文献中尚未对此进行描述。回顾我们患者的临床病程和肝脏尸检情况,他在开始抗病毒治疗时出现了慢性乙型肝炎病毒的严重急性加重,而潜在的HL可能调节了肝损伤的总体程度。