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Hepatic graft-versus-host disease presenting as an acute hepatitis after allogeneic peripheral blood stem cell transplantation

Bone Marrow Transplantation volume 27, pages 1007–1010 (2001)Cite this article

Abstract

Hepatic graft-versus-host disease (GVHD) generally presents as cholestatic jaundice, and increased serum alkaline phosphatase (ALP) is followed by hyperbilirubinemia and clinical jaundice. Currently accepted standards for evaluating the clinical severity of GVHD are based not on serum aminotransferase levels but on the serum bilirubin level. We describe a 17-year-old Japanese female who had increased aminotransferases without cholestasis on day 23 after allogeneic peripheral blood stem cell transplantation (allo-PBSCT). Liver biopsy revealed lymphocytic infiltration of the portal tracts and pericentral necrosis of the lobuli. The limiting plates were not clearly defined due to cellular infiltrates. There was periductal lymphocytic infiltration and vacuolization of the biliary epithelial cells with exocytosis, compatible with GVHD of cholangiohepatitic type. These findings indicate that acute hepatic GVHD may present as acute hepatitis and this should be included in the differential diagnosis for patients with increased aminotransferases after allogeneic stem cell transplantation. Bone Marrow Transplantation (2001) 27, 1007–1010.

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Authors and Affiliations

  1. Department of Internal Medicine II, Okayama University Medical School, Okayama, Japan

    N Fujii, K Takenaka, K Shinagawa, K Ikeda, Y Maeda, K Sunami, Y Hiramatsu, K Matsuo, F Ishimaru, K Niiya & M Harada

  2. Department of Pathology II, Okayama University Medical School, Okayama, Japan

    T Yoshino

  3. Division of Pathology, Japanese Red Cross Nagoya First Hospital, Nagoya, Japan

    N Hirabayashi

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  1. N Fujii
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Fujii, N., Takenaka, K., Shinagawa, K. et al. Hepatic graft-versus-host disease presenting as an acute hepatitis after allogeneic peripheral blood stem cell transplantation. Bone Marrow Transplant 27, 1007–1010 (2001). https://doi.org/10.1038/sj.bmt.1702997

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  • DOI: https://doi.org/10.1038/sj.bmt.1702997

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