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Acute liver failure as the initial manifestation of acute leukaemia

Authors


Simon H. C. Anderson, Gastrointestinal Laboratory, The Rayne Institute, St Thomas’ Hospital, London, SE1 7EH, UK
Tel: 44 207 928 9292 ext. 2650
Fax: 44 207 960 5710
e-mail: simon.anderson@kcl.ac.uk

Abstract

Abstract:Background/Aims: Haematological malignancies seldom cause clinically significant liver disease. Acute liver failure as the initial manifestation of acute leukaemia is very rare and carries a very poor prognosis. Methods/Results: Three cases of acute liver failure secondary to acute leukaemia are described. Each case presented initially as acute liver failure of uncertain cause. Specific treatment for the leukaemia was instituted; however, all three patients died as a consequence of the liver failure. We describe the clinical course and relevant investigations of these patients and discuss possible mechanisms of acute liver failure in this setting. Conclusion: Acute leukaemia presenting as acute liver failure has a very poor prognosis. Although a rare cause of acute liver failure, it should be considered in any patient presenting with acute liver failure with prodromal symptoms and a raised peripheral white cell count, lactate dehydrogenase and uric acid.

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