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首页> 外文期刊>DMW: Deutsche Medizinische Wochenschrift >Impending liver failure after chemoimmunotherapy-induced reactivation of hepatitis B - Successful treatment with entecavir [Drohendes Leberversagen nach Chemoimmuntherapie-induzierter Reaktivierung einer Hepatitis B - erfolgreiche Therapie mit Entecavir]
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Impending liver failure after chemoimmunotherapy-induced reactivation of hepatitis B - Successful treatment with entecavir [Drohendes Leberversagen nach Chemoimmuntherapie-induzierter Reaktivierung einer Hepatitis B - erfolgreiche Therapie mit Entecavir]

机译：化学免疫疗法诱发的乙型肝炎激活后即将发生的肝功能衰竭-恩替卡韦成功治疗[化学免疫疗法诱发的乙型肝炎激活后即将出现的肝功能衰竭-恩替卡韦成功治疗]

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History and clinical findings: An 83-year old woman had been treated with bendamustin and rituximab for prolymphocytic leukemia. Two weeks after cycle 6 of chemotherapy, signs and symptoms of a severe hepatitis occurred. Investigations: Highly elevated values for AST (1353 U/l) and bilirubin (27.8 mg/dl), impaired coagulation parameters (INR 1,68) and the detection of ascites led to the diagnosis of an impending liver failure induced by reactivation of a hitherto unknown hepatitis B (HBs antigen pos., HBe antigen pos., anti HBc IgG pos., HBV DNA 1,65 Mio copies/ml). Treatment and course: After an immediately started treatment with entecavir (0.5 mg/d po), symptoms and laboratory parameters rapidly improved. 4 months later liver chemistry was completely normal and HBV DNA was negative. After 8 months, a seroconversion to anti HBs was noted. Conclusion: In single cases, life threatening complications of chemotherapy induced reactivation of hepatitis B may be successfully treated by potent and stabile nucleosidanalogs.
机译：病史和临床发现：一名83岁的妇女接受了苯达莫司汀和利妥昔单抗治疗前淋巴细胞白血病。化疗周期6后两周，发生了严重肝炎的体征和症状。研究：AST（1353 U / l）和胆红素（27.8 mg / dl）的高度升高，凝血参数受损（INR 1,68）以及腹水的检测导致诊断为由肝素再激活引起的即将发生的肝衰竭。迄今未知的乙型肝炎（HBs抗原，HBe抗原，抗HBc IgG抗体，HBV DNA 1,65 Mio拷贝/ ml）。治疗和疗程：立即开始使用恩替卡韦（0.5 mg / d po）治疗后，症状和实验室指标迅速改善。 4个月后，肝化学完全正常，HBV DNA阴性。 8个月后，发现血清已转化为抗HBs。结论：在单个病例中，有效且稳定的核苷类似物可成功治愈化疗诱导的乙型肝炎再激活的危及生命的并发症。

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