DeFilippis Ersilia M, Ludwig Emmy
Department of Medicine, Memorial Sloan Kettering Cancer Center, Gastroenterology and Nutrition Service, New York, NY 10065, USA.
J Gastrointest Oncol. 2015 Oct;6(5):E66-9. doi: 10.3978/j.issn.2078-6891.2015.042.
Reactivation of hepatitis B viral infection (HBVr) is a known risk in cancer patients with a history of chronic hepatitis B infection receiving cytotoxic or immunosuppressive therapies. Patients with hematologic malignancies or those who have received stem cell transplantation seem to be most at risk but reactivation has been reported with various malignancies. Reactivation can present as asymptomatic liver function test abnormalities (LFTs), with symptoms of abdominal pain, encephalopathy, or as fulminant hepatitis and liver failure. Here we report the first case of a patient with islet cell tumor on octreotide and sirolimus who developed hepatitis B reactivation with fulminant liver failure and death.
乙型肝炎病毒感染再激活(HBVr)是有慢性乙型肝炎感染史的癌症患者接受细胞毒性或免疫抑制治疗时已知的风险。血液系统恶性肿瘤患者或接受过干细胞移植的患者似乎风险最高,但各种恶性肿瘤患者均有再激活的报道。再激活可表现为无症状的肝功能检查异常(LFTs)、伴有腹痛、脑病症状,或表现为暴发性肝炎和肝衰竭。在此,我们报告首例接受奥曲肽和西罗莫司治疗的胰岛细胞瘤患者发生乙型肝炎再激活并导致暴发性肝衰竭和死亡的病例。