Hodgkin lymphoma associated vanishing bile duct syndrome treated successfully with a brentuximab based regimen

BMJ Case Rep. 2023 Nov 21;16(11):e257211. doi: 10.1136/bcr-2023-257211.

Abstract

We report a combination therapy to successfully treat a patient with Hodgkin's lymphoma complicated by vanishing bile duct syndrome. Our patient was in his 20s and presented with jaundice, emesis, B symptoms and diffuse lymphadenopathy along with cholestatic liver injury prompting a liver biopsy, which revealed this diagnosis, after the exclusion of other aetiologies. Our treatment regimen incorporated brentuximab along with other more conventional agents which attempted to maximise therapeutic efficacy while minimising the consequences of hepatotoxicity on the treatment protocol. Although this patient's treatment course was complicated because of neutropenic infections, the patient achieved a complete metabolic response and is now more than 1 year off therapy.

Keywords: Cancer intervention; Gastroenterology; Paediatric oncology.

Publication types

  • Case Reports

MeSH terms

  • Adult
  • Antibodies, Monoclonal / therapeutic use
  • Antineoplastic Agents* / therapeutic use
  • Bile Ducts / pathology
  • Cholestasis* / drug therapy
  • Cholestasis* / etiology
  • Cholestasis* / pathology
  • Clinical Protocols
  • Hodgkin Disease* / complications
  • Hodgkin Disease* / drug therapy
  • Hodgkin Disease* / pathology
  • Humans
  • Liver / pathology
  • Male

Substances

  • Antibodies, Monoclonal
  • Antineoplastic Agents