Acute liver decompensation on withdrawal of cytotoxic chemotherapy and immunosuppressive therapy in hepatitis B carriers.

摘要: Five chronic carriers of hepatitis B virus developed a fulminant hepatitis-like picture when immunosuppression or cytotoxic treatment, given for unrelated disorders, was withdrawn. Viral replication at the time final illness confirmed in three five cases by measurement serum HBV DNA presence HBc antigen on liver biopsy. A cytoplasmic and nuclear pattern seen histological material during life, but post-mortem limited to distribution, suggesting greater destruction hepatocytes containing HBc. In two cases, disease found post-mortem, there being no previous clinical laboratory abnormality, it is unlikely that this factor development superimposed fulminating illness. Immunosuppressive agents must be used with extreme caution any carrier, as withdrawal can precipitate acute decompensation regardless whether not underlying disease.