一名骨髓增生异常综合征患者因急性髓系白血病肝实质浸润导致急性肝衰竭。
Acute liver failure due to liver parenchymal infiltration with acute myelogenous leukaemia in a patient with myelodysplastic syndrome.
作者信息
Sobotka Lindsay A, Malli Ahmad, Chen Wei, Mumtaz Khalid
机构信息
Department of Internal Medicine, The Ohio State Wexner Medical Center, Columbus, Ohio, USA.
Department of Gastroenterology, Hepatology and Nutrition, The Ohio State Wexner Medical Center, Columbus, Ohio, USA.
出版信息
BMJ Case Rep. 2018 Jun 28;2018:bcr-2018-224590. doi: 10.1136/bcr-2018-224590.
Liver involvement by acute leukaemia is rare and has a high mortality rate despite treatment. We report a case of a 66-year-old woman undergoing treatment for myelodysplastic syndrome with Vidaza (azacitidine) who presented with abnormal liver function tests. Despite negative serologic testing and unremarkable abdominal MRI, she continued to have significant elevation in bilirubin and international normalised ratio and worsening mental status. Liver biopsy was obtained and consistent with acute myelogenous leukaemia. The patient had rapid demise due to acute liver failure and was unable to undergo treatment.
急性白血病累及肝脏的情况罕见，即便接受治疗，死亡率也很高。我们报告一例66岁女性，她正在接受维达莎（阿扎胞苷）治疗骨髓增生异常综合征，出现了肝功能检查异常。尽管血清学检测呈阴性且腹部磁共振成像无异常，但她的胆红素和国际标准化比值仍持续显著升高，精神状态也不断恶化。进行了肝活检，结果符合急性髓系白血病。该患者因急性肝衰竭迅速死亡，无法接受治疗。
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