Case Report
Copyright ©2013 Baishideng. All rights reserved.
World J Clin Cases. Apr 16, 2013; 1(1): 37-40
Published online Apr 16, 2013. doi: 10.12998/wjcc.v1.i1.37
Hodgkin’s lymphoma coexisting with liver failure secondary to acute on chronic hepatitis B
Renee Palta, Amy McClune, Karl Esrason
Renee Palta, Karl Esrason, Division of Gastrointestinal and Liver Disease, Department of Transplant Hepatology, Kaiser Permanente Los Angeles Medical Center, Los Angeles, CA 90027, United States
Amy McClune, Division of Hepatology, University of California, Los Angeles, CA 94607, United States
Author contributions: Palta R was responsible for drafting of manuscript; McClune A and Esrason K were responsible for critical revision of manuscript for important intellectual content.
Correspondence to: Dr. Karl Esrason, MD, Division of Gastrointestinal and Liver Disease, Department of Transplant Hepatology, Kaiser Permanente Los Angeles Medical Center, 1526 Edgemont Street, Los Angeles, CA 90027, United States. karl.t.esrason@nsmtp.kp.org
Telephone: +1-323-7836830 Fax: +1-323-7837056
Received: August 15, 2012
Revised: October 4, 2012
Accepted: November 11, 2012
Published online: April 16, 2013
Abstract

Acute on chronic liver failure (ACLF) is rarely the initial manifestation of a malignant process or precipitated by the initiation of anti-viral treatment with a nucleoside or nucleotide agent. We report an unusual case of ACLF temporally associated with initiation of Entecavir for treatment of chronic hepatitis B. Early Hodgkin’s lymphoma (HL) was unmasked with initiation of the anti-viral treatment which may have exacerbated ACLF. To the best of our knowledge, this has not been described in the literature. In reviewing our patients clinical course and liver autopsy, he developed a severe acute exacerbation of his chronic hepatitis B virus coinciding with the institution of antiviral therapy and the underlying HL perhaps modulating the overall degree of hepatic injury.

Keywords: Entecavir, Hepatic flare, Fulminant hepatic failure, Chronic hepatitis, Acute liver failure, Hodgkin’s lymphoma