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Case Report
Successful treatment of acute pancreatitis associated with late-onset acute liver GVHD after second allogeneic hematopoietic cell transplantation
Yuka Hosokawa1, Tomomi Toubai1, Rintaro Ohe2, Masashi Hosokawa1, Ryo Sato1, Akane Yamada1, Keiko Aizawa1, Masahito Himuro1, Satoshi Ito1, Masakazu Yamamoto1, Daniel Peltier3, Kenichi Ishizawa1

1Department of Internal Medicine III, Division of Hematology and Cell Therapy, Yamagata University Faculty of Medicine, Yamagata, Japan

2Department of Pathology, Yamagata University Faculty of Medicine, Yamagata, Japan

3Department of Pediatrics, University of Michigan Medical School, Ann Arbor, MI, USA

Keywords
acute graft-versus-host disease (GVHD), acute pancreatitis, corticosteroids, tacrolimus
Submitted:November 1, 2021
Accepted:February 14, 2022
Published online:June 3, 2022

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.

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Online ISSN:2432-7026