B-lymphoblastic leukaemia presenting as intrahepatic cholestasis
  • Daniyal Raza
    Department of Internal Medicine, LSU Health Shreveport, Shreveport, United States
  • Maryam Mubashir
    Department of Gastroenterology and Hepatology, LSU Health Shreveport, Shreveport, United States
  • Karan Sachdeva
    Department of Internal Medicine, LSU Health Shreveport, Shreveport, United States
  • Lena Kawji
    Department of Internal Medicine, LSU Health Shreveport, Shreveport, United States
  • Ashley Deville
    Department of Internal Medicine, LSU Health Shreveport, Shreveport, United States
  • Syed Musa Raza
    Department of Gastroenterology and Hepatology, LSU Health Shreveport, Shreveport, United States
  • James Morris
    Department of Gastroenterology and Hepatology, LSU Health Shreveport, Shreveport, United States
  • Sudha Pandit
    Department of Gastroenterology and Hepatology, LSU Health Shreveport, Shreveport, United States

Keywords

B-ALL, ERCP, intrahepatic cholestasis

Abstract

Acute cholangitis is a critical medical condition requiring prompt intervention. This case report explores the complexities and uncertainties encountered in clinical decision-making when faced with a patient presenting with symptoms suggestive of acute cholangitis. We emphasise the importance of considering individual circumstances and factors in the diagnostic process. A 38-year-old woman with a history of Crohn’s colitis presented with abdominal pain, jaundice and leukocytosis. Initial evaluation raised suspicions of acute cholangitis, but unexpected findings of blast cells in the peripheral smear led to a diagnosis of B-lymphoblastic leukaemia with BCR-ABL1 fusion. Treatment with steroids and chemotherapy resulted in the resolution of liver abnormalities. This case underscores the necessity of comprehensive assessments for obstructive jaundice and highlights the potential diagnostic challenges posed by underlying haematologic malignancies. It also raises awareness about drug-induced liver injury, and emphasises the importance of complete blood counts and differentials in the initial workup. Healthcare providers should be vigilant in considering alternative diagnoses when faced with obstructive jaundice, as misdiagnosis can lead to invasive procedures with potential adverse events.

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    Published: 2023-10-30
    Issue: 2023: Vol 10 No 12 (view)

    How to cite:
    1.
    Raza D, Mubashir M, Sachdeva K, Kawji L, Deville A, Raza SM, Morris J, Pandit S. B-lymphoblastic leukaemia presenting as intrahepatic cholestasis. EJCRIM 2023;10 doi:10.12890/2023_004121.