Liver injury and pancytopenia as initial symptoms of acute lymphoblastic leukaemia A case report 67

Dziurkowska-Marek A, Hartleb M, Pająk J, Krzemień S, Bołdys H, Nowak A, Hołowiecki J. Liver injury and pancytopenia as initial symptoms of acute lymphoblastic leukaemia. A case report. Folia Gastroenterol Hepatol 2006; 4 (2): 67 – 71. Abstract. Haematological malignancies commonly involve the liver, however, they rarely cause clinically significant hepatic disease. Hepatic involvement as the prodromal manifestation of acute leukaemia is exceptional. We describe a 54-year-old female who developed recurrent, symptomatic hepatitis and thrombocytopenia as initial features of acute lymphoblastic leukaemia. Transjugular hepatic biopsy revealed porto-sinusoidal infiltration with blast-cells. At immunohistochemistry the infiltrating cells shared the phenotypic characteristics of the medullary infiltrate. The patient was treated with a PALG 4-2002 chemotherapy regimen, which led to partial remission of haematological disease and normalization of hepatic laboratory tests.