Successful treatment of acute pancreatitis associated with late-onset acute liver GVHD after second allogeneic hematopoietic cell transplantation

Yuka Hosokawa; Tomomi Toubai; Rintaro Ohe; Masashi Hosokawa; Ryo Sato; Akane Yamada; Keiko Aizawa; Masahito Himuro; Satoshi Ito; Masakazu Yamamoto; Daniel Peltier; Kenichi Ishizawa

doi:10.31547/bct-2021-023

Successful treatment of acute pancreatitis associated with late-onset acute liver GVHD after second allogeneic hematopoietic cell transplantation

Blood Cell Ther. 2022 Jun 3;5(3):79-82. doi: 10.31547/bct-2021-023. eCollection 2022 Aug 25.

Authors

Affiliations

¹ Department of Internal Medicine III, Division of Hematology and Cell Therapy, Yamagata University Faculty of Medicine, Yamagata, Japan.
² Department of Pathology, Yamagata University Faculty of Medicine, Yamagata, Japan.
³ Department of Pediatrics, University of Michigan Medical School, Ann Arbor, MI, USA.

Abstract

We report the case of a 28-year-old woman who developed upper abdominal pain and jaundice after a second unrelated allogeneic hematopoietic cell transplantation (allo-HCT) for acute lymphoid leukemia (ALL). Laboratory data showed elevated levels of liver enzymes, amylase, and lipase. Although acute pancreatitis was suspected, no structural lesions were detected. Liver biopsy was compatible with late-onset acute graft-versus-host disease (GVHD), which resolved following treatment with methylprednisolone (mPSL) and tacrolimus (TAC). In addition, her serum amylase level and abdominal pain rapidly resolved following acute GVHD-directed therapy. Acute pancreatitis concomitant with late-onset acute liver GVHD is extremely rare and has not been documented subsequent to a second allo-HCT.

Keywords: acute graft-versus-host disease (GVHD); acute pancreatitis; corticosteroids; tacrolimus.

Publication types

Case Reports