Differences in liver pathology and clinical outcome between two patients with Hepatitis B virus and graft versus host disease


Üstün C., ÖZCAN M., GÜRMAN G., Çakir M., Erekul S., AKYOL G., ...Daha Fazla

Pathology and Oncology Research, cilt.5, sa.3, ss.229-232, 1999 (SCI-Expanded) identifier identifier

  • Yayın Türü: Makale / Tam Makale
  • Cilt numarası: 5 Sayı: 3
  • Basım Tarihi: 1999
  • Doi Numarası: 10.1053/paor.1999.0229
  • Dergi Adı: Pathology and Oncology Research
  • Derginin Tarandığı İndeksler: Science Citation Index Expanded (SCI-EXPANDED), Scopus
  • Sayfa Sayıları: ss.229-232
  • Anahtar Kelimeler: AlloBMT, Graft versus-host disease, Hepatitis B virus
  • Ankara Üniversitesi Adresli: Evet

Özet

Our two patients undergoing allogeneic bone marrow transplantation (AlloBMT) had both Hepatitis B virus (HBV) and graft-versus-host disease (GVHD). In the first patient, liver enzymes elevated three months after AlloBMT, and GVHD was diagnosed. Two weeks after the diagnosis of GVHD, HBsAg appeared in his serum. At that time, liver biopsy was not able to discriminate two disorders, but his sequential liver biopsies disclosed GVHD. Despite the patient was treated with cyclosporin A (CsA), he died for chronic GVHD. In contrast to the first patient, the second patient had HBsAg prior to GVHD. His liver enzymes deterioration was detected in the first month after AlloBMT, and reached the highest level in the third month while withdrawing CsA. In the fifth month he developed scleradermatous skin changes, and skin biopsy revealed chronic GVHD, whereas concurrent liver biopsy revealed chronic active hepatitis. This observation showed that immunosuppressive conditions such as GVHD or its prophylaxis may affect the appearance of liver pathology caused by HBV, which depends on the time of GVHD development, and the duration and depth of GVHD prophylaxis.