Gholson C F, Yau J C, LeMaistre C F, Cleary K R
Department of Medical Oncology, University of Texas M.D. Anderson Cancer Center, Houston.
Am J Gastroenterol. 1989 Oct;84(10):1306-9.
A 29-yr-old woman developed severe, progressive cholestasis 5 months after allogeneic bone marrow transplantation. Extrahepatic graft-versus-host disease (GVHD) was absent. Skin biopsy was equivocal 2 months after transplant, rash was absent during the period of cholestasis, and cholangiographic abnormalities were absent. Liver biopsy 7.5 months posttransplant revealed chronic hepatic GVHD. Cholestasis dramatically resolved with high dose corticosteroid therapy. Chronic hepatic GVHD occurs in the absence of overt extraintestinal GVHD and respond promptly to therapy. This underscores the importance of aggressive diagnostic evaluation of posttransplant cholestasis.
一名29岁女性在异基因骨髓移植后5个月出现严重的进行性胆汁淤积。无肝外移植物抗宿主病（GVHD）。移植后2个月皮肤活检结果不明确，胆汁淤积期间无皮疹，胆管造影无异常。移植后7.5个月的肝脏活检显示为慢性肝脏GVHD。高剂量皮质类固醇治疗后胆汁淤积显著缓解。慢性肝脏GVHD在无明显肠道外GVHD的情况下发生，且对治疗反应迅速。这突出了对移植后胆汁淤积进行积极诊断评估的重要性。
