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Drug-induced liver injury after allogeneic bone marrow transplantation

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Abstract

A 23-year-old woman developed acute severe hepatitis and jaundice on day 183 after bone marrow transplantation from HLA-B antigen mismatched-related donor. The administration of prednisolone and cessation of the prescribed drugs resolved the liver injury. Drug lymphocyte stimulation test was positive for acyclovir, and liver biopsy indicated the characteristics of drug-induced liver injury (DILI) rather than graft-versus-host disease. Physicians should keep DILI in mind when considering differential diagnosis for liver complications after allogeneic cell transplantation.

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References

  1. Hogan WJ, Maris M, Storer B, Sandmaier BM, Maloney DG, Schoch HG, et al. Hepatic injury after nonmyeloablative conditioning followed by allogeneic hematopoietic cell transplantation: a study of 193 patients. Blood. 2004;103(1):78–84.

    Article  PubMed  CAS  Google Scholar 

  2. Levitsky J, Sorrell MF. Hepatic complications of hematopoietic cell transplantation. Curr Gastroenterol Rep. 2007;9(1):60–5.

    Article  PubMed  Google Scholar 

  3. Kusumi E, Kami M, Kanda Y, Murashige N, Seki K, Fujiwara M, et al. Hepatic injury following reduced intensity unrelated cord blood transplantation for adult patients with hematological diseases. Biol Blood Marrow Transplant. 2006;12(12):1302–9.

    Article  PubMed  Google Scholar 

  4. Aithal GP, Watkins PB, Andrade RJ, Larrey D, Molokhia M, Takikawa H, et al. Case definition and phenotype standardization in drug-induced liver injury. Clin Pharmacol Ther. 2011;89(6):806–15.

    Article  PubMed  CAS  Google Scholar 

  5. García-Cortés M, Lucena MI, Pachkoria K, Borraz Y, Hidalgo R, Andrade RJ, Spanish Group for the Study of Drug-induced Liver Disease (grupo de EstudioparalasHepatopatíasAsociadas a Medicamentos, Geham). Evaluation of naranjo adverse drug reactions probability scale in causality assessment of drug-induced liver injury. Aliment Pharmacol Ther. 2008;27(9):780–9.

    Article  PubMed  Google Scholar 

  6. Naranjo CA, Busto U, Sellers EM, Sandor P, Ruiz I, Roberts EA, et al. A method for estimating the probability of adverse drug reactions. Clin Pharmacol Ther. 1981;30:239–45.

    Article  PubMed  CAS  Google Scholar 

  7. Danan G, Benichou C. Causality assessment of adverse reactions to drugs-I. A novel method based on the conclusions of international consensus meetings: application to drug-induced liver injuries. J Clin Epidemiol. 1993;46(11):1323–30.

    Article  PubMed  CAS  Google Scholar 

  8. Maria VA, Victorino RM. Development and validation of a clinical scale for the diagnosis of drug-induced hepatitis. Hepatology. 1997;26(3):664–9.

    Article  PubMed  CAS  Google Scholar 

  9. Watanabe M, Shibuya A. Validity study of a new diagnostic scale for drug-induced liver injury in Japan-comparison with two previous scales. Hepatol Res. 2004;30(3):148–54.

    Article  PubMed  CAS  Google Scholar 

  10. Amigues I, Cohen N, Chung D, Seo SK, Plescia C, Jakubowski A, et al. Hepatic safety of voriconazole after allogeneic hematopoietic stem cell transplantation. Biol Blood Marrow Transplant. 2010;16(1):46–52.

    Article  PubMed  CAS  Google Scholar 

  11. McDonald GB, Slattery JT, Bouvier ME, Ren S, Batchelder AL, Kalhorn TF, et al. Cyclophosphamide metabolism, liver toxicity, and mortality following hematopoietic stem cell transplantation. Blood. 2003;101(5):2043–8.

    Article  PubMed  CAS  Google Scholar 

  12. Goekkurt E, Stoehlmacher J, Stueber C, Wolschke C, Eiermann T, Iacobelli S, et al. Pharmacogenetic analysis of liver toxicity after busulfan/cyclophosphamide-based allogeneic hematopoietic stem cell transplantation. Anticancer Res. 2007;27(6C):4377–80.

    PubMed  CAS  Google Scholar 

  13. McCune JS, Batchelder A, Deeg HJ, Gooley T, Cole S, Phillips B, et al. Cyclophosphamide following targeted oral busulfan as conditioning for hematopoietic cell transplantation: pharmacokinetics, liver toxicity, and mortality. Biol Blood Marrow Transplant. 2007;13(7):853–62.

    Article  PubMed  CAS  Google Scholar 

  14. Tajiri K, Shimizu Y. Practical guidelines for diagnosis and early management of drug-induced liver injury. World J Gastroenterol. 2008;14(44):6774–85.

    Article  PubMed  Google Scholar 

  15. Takikawa H. Recent status of drug-induced liver injury. Hepatol Res. 2009;39(1):1–6.

    Article  PubMed  CAS  Google Scholar 

  16. Watkins PB. Biomarkers for the diagnosis and management of drug-induced liver injury. Semin Liver Dis. 2009;29(4):393–9.

    Article  PubMed  CAS  Google Scholar 

  17. Sembera S, Lammert C, Talwalkar JA, Sanderson SO, Poterucha JJ, Hay JE, et al. Frequency, clinical presentation, and outcomes of drug-induced liver injury after liver transplantation. Liver Transpl. 2012;18(7):803–10.

    Article  PubMed  Google Scholar 

  18. Zhenglu W, Hui L, Shuying Zh, Wenjuan C, Zhongyang Sh. A clinical-pathological analysis of drug-induced hepatic injury after liver transplantation. Transplant Proc. 2007;39(10):3287–91.

    Article  PubMed  CAS  Google Scholar 

  19. Quaglia A, Duarte R, Patch D, Ngianga-Bakwin K, Dhillon AP. Histopathology of graft versus host disease of the liver. Histopathology. 2007;50(6):727–38.

    Article  PubMed  CAS  Google Scholar 

  20. Maeng H, Lee JH, Cheong JW, Lee ST, Hahn JS, Ko YW, et al. Chronic graft-versus-host disease of the liver presenting as an acute hepatitis following non myeloablative hematopoietic stem cell transplantation. Int J Hematol. 2004;79(5):501–4.

    Article  PubMed  Google Scholar 

  21. Lee S-E, Cho B-S, Kim J-H, Yoon J-H, Shin S-H, Yahng S-A, et al. Risk and prognostic factors for acute GVHD based on NIH consensus criteria. Bone Marrow Transplant. 2013;48:587–92.

    Article  PubMed  Google Scholar 

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Conflict of interest

The authors have no conflicts of interest.

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Authors and Affiliations

  1. Department of Hematology, Yokohama City University Medical Center, Yokohama, Japan

    Takayoshi Tachibana, Eri Yamamoto, Rika Kawasaki, Hideyuki Koharazawa, Maki Hagihara, Daisuke Ishibashi, Yuki Nakajima, Hideyuki Kuwabara & Shin Fujisawa

  2. Department of Transfusion Medicine, Yokohama City University Medical Center, Yokohama, Japan

    Akito Nozaki

  3. Department of Internal Medicine and Clinical Immunology, Yokohama City University Graduate School of Medicine, 3-9 Fukuura, Kanazawa-ku, Yokohama, 236-0004, Japan

    Takayoshi Tachibana, Naoto Tomita & Yoshiaki Ishigatsubo

  4. Department of Pathology, Yokohama City University Graduate School of Medicine, Yokohama, Japan

    Makiko Enaka

Authors
  1. Takayoshi Tachibana
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  2. Akito Nozaki
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  3. Makiko Enaka
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  4. Eri Yamamoto
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  6. Hideyuki Koharazawa
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  7. Maki Hagihara
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  8. Daisuke Ishibashi
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  9. Yuki Nakajima
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  10. Hideyuki Kuwabara
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  11. Naoto Tomita
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  12. Yoshiaki Ishigatsubo
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  13. Shin Fujisawa
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Corresponding author

Correspondence to Takayoshi Tachibana.

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Tachibana, T., Nozaki, A., Enaka, M. et al. Drug-induced liver injury after allogeneic bone marrow transplantation. Int J Hematol 98, 499–503 (2013). https://doi.org/10.1007/s12185-013-1434-5

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  • DOI: https://doi.org/10.1007/s12185-013-1434-5

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