Hepatic dysfunction due to symptomatic cholelithiasis during treatment of complications after two courses of hematopoietic stem cell transplantation in a girl with acute myelogenous leukemia

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  • Sato Tomonobu
    Department of Pediatrics, Kitami Red Cross Hospital
  • Endo Megumi
    Department of Pediatrics, Kitami Red Cross Hospital
  • Sugiyama Minako
    Department of Pediatrics, Hokkaido University Graduate School of Medicine
  • Terashita Yukayo
    Department of Pediatrics, Hokkaido University Graduate School of Medicine
  • Cho Yuko
    Department of Pediatrics, Hokkaido University Graduate School of Medicine
  • Iguchi Akihiro
    Department of Pediatrics, Hokkaido University Graduate School of Medicine

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  • 二度の造血幹細胞移植後合併症の治療中に症候性胆石症による肝障害を来した急性骨髄性白血病の女児例

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Abstract

<p>Hematopoietic stem cell transplantation (HSCT) increases the risk of cholelithiasis. Herein, we describe the case of an acute myelogenous leukemia (AML) patient presenting with hepatic dysfunction secondary to cholelithiasis during extensive chronic graft versus host disease (GVHD) following two courses of HSCT. Following a second relapse, haploidentical peripheral blood stem cell transplantation (PBSCT) induced complete remission. One year following PBSCT, the patient presented with abdominal pain and elevation of levels of serum transaminase and biliary enzymes. Although hepatic dysfunction was suspected to be due to extensive chronic GVHD, abdominal ultrasonography, however, revealed multiple gallstones, and she was diagnosed as having symptomatic cholelithiasis. Conservative therapy aided her recovery, and follow-up by regular abdominal ultrasonography was conducted. Risk factors for pediatric cholelithiasis following HSCT include multiple courses of HSCT, donor–recipient human leukocyte antigen mismatch, and GVHD. For patients who have undergone HSCT and have multiple risk factors for cholelithiasis, it is necessary to consider aggressive abdominal ultrasonography because of its convenience and non-invasiveness.</p>

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