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Vanishing bile duct syndrome in Hodgkin's lymphoma: A case report and literature review

World Journal of Gastroenterology 2017年第2期23卷 366-372页

作者： mena bakhit Thomas R McCarty Sunhee Park Basile Njei Margaret Cho Raffi Karagozian AnnMarie Liapakis Department of Internal Medicine Yale University School of Medicine Section of Digestive Diseases Yale University School of Medicine Investigative Medicine Program Yale Center of Clinical Investigation Department of Anatomic Pathology Yale University School of Medicine Saint Francis Hospital Gastroenterology and Hepatology

Vanishing bile duct syndrome(VBDS) has been described in different pathologic conditions including infection, ischemia, adverse drug reactions, autoimmune diseases, allograft rejection, and humoral factors associated with malignancy. It is an acquired condition characterized by progressive destruction and loss of the intra-hepatic bile ducts leading to cholestasis. Prognosis is variable and partially dependent upon the etiology of bile duct injury. Irreversible bile duct loss leads to significant ductopenia, biliary cirrhosis, liver failure, and death. If biliary epithelial regeneration occurs, clinical recovery may occur over a period of months to years. VBDS has been described in a number of cases of patients with Hodgkin's lymphoma(HL) where it is thought to be a paraneoplastic phenomenon. This case describes a 25-year-old man found on liver biopsy to have VBDS. Given poor response to medical treatment, the patient underwent transplant evaluation at that time and was found to have classical stage ⅡB HL. Early recognition of this underlying cause or association of VBDS, including laboratory screening, and physical exam for lymphadenopathy are paramount to identifying potential underlying VBDS-associated malignancy. Here we review the literature of HL-associated VBDS and report a case of diagnosed HL with biopsy proven VBDS.

关键词： Cholestasis 胆汁 ductopenia 消失的胆汁管症候群 Hodgkin’ s 淋巴瘤肝

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