Case Reports in Hepatology最新文献

{"title":"Vanishing Bile Duct Syndrome as an Uncommon Hepatic Paraneoplastic Syndrome in Hodgkin's Lymphoma.","authors":"Natasha Salman, Diana Sittirat Petchpailin, Amanda Seemann, Apurva Modi, Rohan Gupta, Shovendra Gautam","doi":"10.1155/crhe/4166844","DOIUrl":"10.1155/crhe/4166844","url":null,"abstract":"<p><p>Vanishing bile duct syndrome (VBDS) is a rare form of liver injury caused by ischemia, drug reactions, autoimmune diseases, infections, or malignancy. VBDS involves the progressive disappearance of intrahepatic bile ducts, causing cholestasis and biliary cirrhosis, with high mortality if untreated. VBDS can also present as a paraneoplastic syndrome in Hodgkin's lymphoma (HL). A 53-year-old female presented with jaundice, pruritus, diarrhea, and elevated liver function tests (LFTs). A liver biopsy demonstrated cholestasis with mild ductopenia, and imaging revealed enlarged para-aortic lymph nodes. A bone marrow biopsy confirmed HL, and chemotherapy normalized symptoms and LFTs.</p>","PeriodicalId":30295,"journal":{"name":"Case Reports in Hepatology","volume":"2026 ","pages":"4166844"},"PeriodicalIF":0.0,"publicationDate":"2026-02-10","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12891432/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"146182733","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Exceptionally Long Recurrence-Free Survival in a Male Patient With Fibrolamellar Hepatocellular Carcinoma.","authors":"Elizabeth C Townsend, Disha Sharma, Harish Gopalakrishna, Maria Mironova, David E Kleiner, Theo Heller","doi":"10.1155/crhe/7445319","DOIUrl":"10.1155/crhe/7445319","url":null,"abstract":"<p><p>Fibrolamellar hepatocellular carcinoma (FLHCC) accounts for less than 1% of all primary liver cancers. Due to an absence of known risk factors, most individuals are diagnosed at advanced stages of disease. Subsequently, these tumors carry a 30%-50% mortality rate and a 33%-100% recurrence rate in those treated with curative intent. Here, we describe an incidental discovery of an FLHCC tumor in a young male patient, who following surgical resection has remained recurrence free for over 11 years. This exceptionally long recurrence-free survival highlights the advantage of early-stage detection, the benefit of complete tumor resection, and further underscores the importance of regular postresection cancer surveillance.</p>","PeriodicalId":30295,"journal":{"name":"Case Reports in Hepatology","volume":"2026 ","pages":"7445319"},"PeriodicalIF":0.0,"publicationDate":"2026-02-08","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12883663/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"146158337","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Two Cases of Hepatic Epithelioid Hemangioendothelioma Misdiagnosed With Hepatic Veno-Occlusive Disease.","authors":"Bing Zhu, Yiwen Xv, Fangjiao Song, Sa Lv, Jinghui Dong, Shuhong Liu, Shaoli You","doi":"10.1155/crhe/8493924","DOIUrl":"10.1155/crhe/8493924","url":null,"abstract":"<p><p>Hepatic epithelioid hemangioendothelioma (HEHE) is a rare tumor of vascular origin with an incidence of < 0.1/100,000. The disease is easily misdiagnosed. The aim of this article is to increase public awareness and vigilance of HEHE. We report two cases presenting with fever, abdominal discomfort, abnormal liver function, and jaundice. Computed tomography (CT) and magnetic resonance imaging (MRI) of the abdomen suggested hepatic stasis, venous compression, and ascites, and liver biopsy was initially misdiagnosed as hepatic veno-occlusive disease (VOD), which did not improve with treatment. In the first case, a male patient, after liver transplantation, pathological and immunohistochemical (IHC) analyses revealed hyperplasia of blood vessels in the liver tissue with dilated lumen and heterogeneous cells. Immunohistochemistry was performed and showed CD34 positivity, confirming the diagnosis of HEHE. The second female patient had liver bruising and ascites on imaging, and the first hepatic puncture was reported to be VOD, which did not improve with treatment. Repeat hepatic puncture was performed, and the diagnosis of HEHE was confirmed after a second repathology with additional immunohistochemistry for HEHE. These misdiagnosis cases highlight the challenge of diagnosing HEHE. This is the first report of misdiagnosis of HEHE as VOD. This article analyzes the underlying causes of misdiagnosis of HEHE and emphasizes the causes of imaging misdiagnosis and the importance of repeated hepatic puncture biopsy and immunohistochemistry in the diagnosis of HEHE.</p>","PeriodicalId":30295,"journal":{"name":"Case Reports in Hepatology","volume":"2026 ","pages":"8493924"},"PeriodicalIF":0.0,"publicationDate":"2026-01-31","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12859817/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"146107602","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"A Case Report of Direct-Acting Antiviral Therapy for Chronic Hepatitis C in a Patient With Dementia Treated in Collaboration With Multiple Specialists.","authors":"Tomoki Tanie, Kotaro Kanda, Hirotoshi Fujikawa","doi":"10.1155/crhe/5540732","DOIUrl":"https://doi.org/10.1155/crhe/5540732","url":null,"abstract":"<p><p>A 77-year-old female with dementia was transferred from her family clinic to our hospital with a 2-day history of appetite loss and was diagnosed with pneumonia and urinary tract infection upon admission. Laboratory investigation revealed hepatitis C virus antibody positivity and an elevated hepatitis C virus ribonucleic acid level of 3.6 Log IU/mL; therefore, direct-acting antiviral therapy was initiated. Although the patient requested treatment for hepatitis C, managing her medication was difficult because of dementia, as she lived alone and had no family, which required her to take medication under supervision, even on holidays. After discharge, the patient was treated with glecaprevir hydrate and pibrentasvir for 8 weeks by a hepatologist with biweekly visits to monitor adverse events. The hepatitis C virus ribonucleic acid test result was negative after 4 weeks of treatment, and we asked her family physician to confirm a sustained virologic response. Collaboration among multiple specialists, both within and outside the hospital, is essential for facilitating the treatment of such patients.</p>","PeriodicalId":30295,"journal":{"name":"Case Reports in Hepatology","volume":"2026 ","pages":"5540732"},"PeriodicalIF":0.0,"publicationDate":"2026-01-27","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12836034/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"146094077","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Isolated Gallbladder Tuberculosis Mimicking Chronic Cholecystitis: A Case Report.","authors":"Ananya Vig, Dikshit Chawla, Parth Dhamija, Ashwani Kumar, Mansi Singh","doi":"10.1155/crhe/9990210","DOIUrl":"https://doi.org/10.1155/crhe/9990210","url":null,"abstract":"<p><p>Isolated gallbladder tuberculosis (GBTB) is a rare disease, even in endemic areas, and is often misdiagnosed due to its nonspecific clinical and imaging findings. Histopathological evaluation, demonstrating granulomatous inflammation with caseous necrosis, remains the only definitive method of diagnosis. Thus, maintaining a high index of suspicion and routine histological assessment of resected specimens are vital for its timely management, especially in patients with a history of tuberculosis. We report a similar case in a 50-year-old male patient with imaging suggestive of gallbladder perforation and chronic cholecystitis, which later revealed a cryptic GBTB dug up during histopathological examination.</p>","PeriodicalId":30295,"journal":{"name":"Case Reports in Hepatology","volume":"2026 ","pages":"9990210"},"PeriodicalIF":0.0,"publicationDate":"2026-01-27","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12838217/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"146094103","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"An Unforeseen Diagnosis After Liver Transplantation for Acute Liver Failure: Extranodal NK/T-Cell Lymphoma.","authors":"Giulia L Soares, Beatriz B V Weffort, Lucas V S Makarausky, Mariana F Juste, Renata Z Silva, Samira A C Leila, Wysterlanyo K P Barros, Amanda C Saraiva, Guilherme E Felga, Jackson A Barbosa, Nelson Hamerschlak, Marcelo B de Rezende, Vanderlei Segatelli","doi":"10.1155/crhe/9927354","DOIUrl":"10.1155/crhe/9927354","url":null,"abstract":"<p><p>Acute liver failure (ALF) is a medical emergency characterized by hepatic encephalopathy in patients with recent-onset jaundice and coagulopathy. We present a case of a patient who developed ALF secondary to NK/T-cell lymphoma, with the diagnosis confirmed via histopathological analysis of the explanted after liver transplantation. A 50-year-old woman with no significant medical history was transferred to our institution with severe acute liver injury. On admission, she exhibited drowsiness, jaundice, and hepatosplenomegaly. The patient denied alcohol use but reported consuming horsetail tea (<i>Equisetum</i> spp). We hypothesized drug-induced liver injury as the main diagnosis, attributing to the use of horsetail tea. Despite intensive supportive care, her condition continued to deteriorate, prompting urgent deceased-donor liver transplantation. Histopathological analysis of the explant revealed hepatic parenchyma infiltration by atypical lymphoid cells positive for CD2, CD3, CD8, CD56, and CD38, with Ki-67 > 95% and positive EBV in situ hybridization. The graft biopsy and appendix showed identical findings, confirming a high-grade Stage IV extranodal NK/T-cell lymphoma (ENKTL). Given her critical condition, a modified chemotherapy regimen was initiated. Subsequent complications included severe chemotherapy-induced pancytopenia, febrile neutropenia, invasive aspergillosis, and multiorgan failure, culminating in death 33 days post-transplant. This case highlights the diagnostic challenges of rare non-Hodgkin lymphoma with extranodal presentations. Although horsetail tea is associated with liver injury, its contribution to ALF remains insufficiently defined, reinforcing the importance of excluding alternative causes. ENKTL and other malignancies should be considered in indeterminate ALF, even without imaging findings, atypical lymphocytes in peripheral blood/ascites, or overt clinical suspicion of malignancy.</p>","PeriodicalId":30295,"journal":{"name":"Case Reports in Hepatology","volume":"2026 ","pages":"9927354"},"PeriodicalIF":0.0,"publicationDate":"2026-01-14","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12800736/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145991142","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"DPMAS in the Management of Severe Acute Liver Injury.","authors":"Maiko Alejandro Tavera Díaz, Annia Aguilar Loayza, Carolina Beatriz Mejía Vargas, Juan Fernando Mamani Ochoa","doi":"10.1155/crhe/6456187","DOIUrl":"10.1155/crhe/6456187","url":null,"abstract":"<p><strong>Background: </strong>Acute liver injury is a severe disease in which a hepatic and later systemic inflammatory response is triggered, generally induced by paracetamol intoxication, undetermined causes, drugs, and hepatotropic and nonhepatotropic viruses.</p><p><strong>Case summary: </strong>A 67-year-old immunocompetent male with severe acute liver injury secondary to <i>Cytomegalovirus</i> (CMV) infection presented with a 2-week history of anorexia, asthenia, adynamia, generalized weakness, myalgia, and jaundice. Laboratory tests revealed hyperbilirubinemia, hypertransaminasemia, coagulopathy, and acute kidney injury, and tests for hepatitis A, B, C, HIV, and autoimmune hepatitis were negative, while PCR was positive for CMV. Patient was treated with N-acetylcysteine, albumin, valganciclovir, and liver support therapy using the dual plasma molecular adsorption system (DPMAS). Fundus examination showed CMV retinitis, and liver biopsy confirmed acute hepatitis with CMV cytopathic changes and areas of hepatocyte regeneration. After 5 sessions of DPMAS and 4 weeks of antiviral therapy, he showed clinical and biochemical improvement with native liver recovery and was discharged with outpatient follow-up.</p><p><strong>Conclusion: </strong>This case highlights the successful early recognition and prompt initiation of appropriate treatment using antiviral therapy and liver support therapy in managing severe CMV-induced acute liver injury in an immunocompetent patient, potentially averting the need for liver transplantation.</p>","PeriodicalId":30295,"journal":{"name":"Case Reports in Hepatology","volume":"2026 ","pages":"6456187"},"PeriodicalIF":0.0,"publicationDate":"2026-01-13","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12800567/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145991173","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Primary Biliary Cholangitis With Incomplete Response to Conventional Therapies But Had Complete Response to Baricitinib: A Case Report.","authors":"Gi Eun Kim, Mariam Imran, Sherif Mostafa, Yasser Kamel","doi":"10.1155/crhe/9033401","DOIUrl":"10.1155/crhe/9033401","url":null,"abstract":"<p><p>Primary biliary cholangitis is a progressive disease with complications such as liver cirrhosis and hepatocellular carcinoma, and the treatment goal is to delay its progression. One of the markers for treatment response is alkaline phosphatase levels. Baricitinib has been used in one randomized controlled trial involving two patients to improve outcomes in unresponsive primary biliary cholangitis. We present a case of primary biliary cholangitis who had incomplete response to ursodeoxycholic acid, obeticholic acid, and fenofibrate but showed complete response to baricitinib in terms of sustained normalized alkaline phosphatase levels.</p>","PeriodicalId":30295,"journal":{"name":"Case Reports in Hepatology","volume":"2025 ","pages":"9033401"},"PeriodicalIF":0.0,"publicationDate":"2025-12-28","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12747069/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145865968","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Late Parotid Recurrence of Hepatocellular Carcinoma Following Liver Transplantation: A Case Report.","authors":"Anthony Onde Morada, Caroline Kai Chen, Clifford Akateh, Michael R Marvin, Anil Kotru","doi":"10.1155/crhe/2965476","DOIUrl":"10.1155/crhe/2965476","url":null,"abstract":"<p><p>Metastatic recurrence to the parotid gland following liver transplantation has not been previously reported. We describe a case of a 63-year-old man with hepatocellular carcinoma secondary to alcoholic cirrhosis who was treated with transarterial chemoembolization and microwave ablation, achieving radiographic downstaging within the Milan criteria. He underwent liver transplantation with an exception Model for End-Stage Liver Disease score of 27. Explant pathology revealed moderately differentiated multifocal tumors with negative margins. He remained recurrence-free for 31 months under protocol-based surveillance. He then developed a facial mass; two core needle biopsies were nondiagnostic. Surgical resection confirmed moderately to poorly differentiated metastatic hepatocellular carcinoma involving the parotid gland and zygomatic arch. Tumor markers rose only modestly at the time of recurrence. Despite targeted therapy and radiation, the disease progressed, culminating in widespread metastasis and death 13 months after recurrence. Immunotherapy was deferred due to the risk of graft rejection, and conversion to an mTOR-based regimen was not recommended. This case highlights the challenges in long-term posttransplant surveillance, diagnostic limitations of core biopsy in atypical lesions, and systemic treatment constraints in immunosuppressed patients.</p>","PeriodicalId":30295,"journal":{"name":"Case Reports in Hepatology","volume":"2025 ","pages":"2965476"},"PeriodicalIF":0.0,"publicationDate":"2025-12-18","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12747107/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145865932","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"A Case of Evolving Hepatotoxicity Following Systemic Drug Reaction to Isoniazid-Rifapentine (3HP).","authors":"Niels Vizgan, Jesse Martinez-Kratz, Chris LaBudde, Fredric Gordon","doi":"10.1155/crhe/2508892","DOIUrl":"10.1155/crhe/2508892","url":null,"abstract":"<p><p>The 3-month, once-weekly regimen of isoniazid plus rifapentine (3HP) is widely used for latent tuberculosis infection (LTBI) because of its shorter duration and favorable adherence compared to isoniazid monotherapy. However, 3HP is associated with hepatotoxicity as well as systemic drug reactions (SDRs), characterized by rapid-onset flu-like symptoms, fever, myalgias, and rash, which may complicate therapy. We describe a healthy 26-year-old male diagnosed with latent tuberculosis who developed acute SDR symptoms accompanied by hepatotoxicity after his third dose of 3HP. The liver injury was initially cholestatic and evolved into a worsening hepatocellular pattern despite discontinuation of 3HP, with gradual normalization over 4 weeks. Autoimmune serologies were briefly positive but resolved spontaneously without intervention. This case illustrates the potential for SDRs with evolving liver injury during 3HP therapy and underscores the importance of early recognition of adverse effects and individualized management.</p>","PeriodicalId":30295,"journal":{"name":"Case Reports in Hepatology","volume":"2025 ","pages":"2508892"},"PeriodicalIF":0.0,"publicationDate":"2025-11-24","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12668847/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145662109","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}