Acute liver failure due to liver parenchymal infiltration with acute myelogenous leukaemia in a patient with myelodysplastic syndrome

BMJ Case Rep. 2018 Jun 28:2018:bcr2018224590. doi: 10.1136/bcr-2018-224590.

Abstract

Liver involvement by acute leukaemia is rare and has a high mortality rate despite treatment. We report a case of a 66-year-old woman undergoing treatment for myelodysplastic syndrome with Vidaza (azacitidine) who presented with abnormal liver function tests. Despite negative serologic testing and unremarkable abdominal MRI, she continued to have significant elevation in bilirubin and international normalised ratio and worsening mental status. Liver biopsy was obtained and consistent with acute myelogenous leukaemia. The patient had rapid demise due to acute liver failure and was unable to undergo treatment.

Keywords: haematology (incl blood transfusion); liver disease.

Publication types

  • Case Reports

MeSH terms

  • Aged
  • Antimetabolites, Antineoplastic / therapeutic use*
  • Azacitidine / therapeutic use*
  • Fatal Outcome
  • Female
  • Humans
  • Leukemia, Myeloid, Acute / drug therapy
  • Leukemia, Myeloid, Acute / physiopathology*
  • Liver / pathology*
  • Liver Failure, Acute / physiopathology*
  • Myelodysplastic Syndromes / complications
  • Myelodysplastic Syndromes / drug therapy
  • Myelodysplastic Syndromes / physiopathology*

Substances

  • Antimetabolites, Antineoplastic
  • Azacitidine