Leukaemia presenting with fulminant hepatic failure in a child

Acute myeloid leukaemia presenting as acute liver failure-a case report and literature review

A 75-year-old woman presented with rapidly progressive fatigue, abdominal pain and jaundice. Physical examination revealed tender abdomen and splenomegaly. Magnetic resonance cholangiogram showed marked hepatomegaly, splenomegaly and scattered nodules or masses in the liver and spleen. The patient expired from multiorgan failure. Autopsy revealed infiltration of the liver, spleen and bone marrow by acute myeloid leukaemia.

Acute lymphoblastic leukemia in an adolescent presenting with acute hepatic failure: A case report

This case report describes a case of an unusual initial presentation of acute lymphoblastic leukemia in a previously healthy 15-year-old boy. He initially presented with a 6-day history of tiredness, decreased oral intake, nausea, vomiting, and jaundice (yellow sclera and dark urine) with evidence of acute hepatic failure, presenting as an increase in alanine aminotransferase (ALT)/aspartate aminotransferase (AST)/total bilirubin and a decrease in prothrombin activity. A complete serological evaluation for liver disease was negative. The levels of serum AST and ALT declined following hepatoprotective treatment. Bone marrow biopsy was diagnostic, revealing 68.15% blasts with markers consistent with acute B-cell lymphoblastic leukemia. This case report emphasizes that acute hepatic failure may be the initial presentation of ALL in an adolescent.