Severe Viral Hepatitis in a Patient with Chronic Lymphocytic Leukemia (CLL) Complicated with Autoimmune Haemolytic Anemia (AIAH), Treated with Steroids - Centre de recherche en cancérologie Nantes-Angers Unité Mixte de Recherche 892 Inserm - 6299 CNRS Accéder directement au contenu
Article Dans Une Revue Journal of Clinical Virology Année : 2015

Severe Viral Hepatitis in a Patient with Chronic Lymphocytic Leukemia (CLL) Complicated with Autoimmune Haemolytic Anemia (AIAH), Treated with Steroids

Résumé

Infectious complications are a major cause of morbidity and mortality in patients with chronic lymphocytic leukemia (CLL) due to impaired immunity secondary to the disease itself and to the immunosuppressive therapies administered to these patients. We report a 78-year-old woman with CLL who was treated with steroids for autoimmune hemolytic anemia (AIHA). A few weeks later, she was admitted for severe acute hepatitis with disseminated intravascular coagulation (DIC). Despite the symptomatic treatment of DIC, standard reanimation and probabilistic antibiotics, the patient died within 24h with severe hepatic failure. Autopsy was in favor of a disseminated viral infection with esophageal, hepatic and pulmonary cytopathologic lesions with acidophilic intranuclear inclusions suggestive of herpes virus, even though HSV 1 and 2, CMV and HHV6 PCRs were negative. This case of severe viral hepatitis with esophagitis occurring three weeks after the introduction of high-dose steroid treatment for AIHA in a CLL patient calls for anti-herpetic prophylaxis in such patients, immunodepressed by their diseases and the treatment they receive.

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Cancer
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Dates et versions

inserm-03402266 , version 1 (25-10-2021)

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Corentin Orvain, Alexandra Ducancelle, Caroline Eymerit-Morin, Marie-Christine Rousselet, Frederic Oberti, et al.. Severe Viral Hepatitis in a Patient with Chronic Lymphocytic Leukemia (CLL) Complicated with Autoimmune Haemolytic Anemia (AIAH), Treated with Steroids. Journal of Clinical Virology, 2015, 62, pp.26. ⟨10.1016/j.jcv.2014.11.013⟩. ⟨inserm-03402266⟩
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