A case of hepatitis E that developed during chemotherapy for malignant
lymphoma and responded to ribavirin
Abstract
The main differentials in cases of sudden elevation of hepatic enzyme
levels during immunochemotherapy are reactivation of hepatitis B virus
or drug-induced liver injury. Here, we report a case of acute liver
injury caused by hepatitis E virus (HEV) during chemotherapy for
malignant lymphoma, wherein the patient was successfully treated and
completed chemotherapy. A 57-year-old woman visited her local doctor
because she felt light and tired. The patient underwent lower
gastrointestinal endoscopy and was diagnosed with a malignant lymphoma
of the small intestine (diffuse large B-cell lymphoma). The patient had
a history of oral consumption of undercooked pork liver to improve
anemia and was diagnosed with acute hepatitis E. Since the patient
responded to chemotherapy, she was treated with single-agent ribavirin
while continuing chemotherapy, resulting in a sustained virological
response. Even during treatment with immunosuppressive drugs, if
appropriate treatment for hepatitis E can be administered, the patient
can be fully treated without interruption. The patient was able to
complete chemotherapy adequately without interruption of treatment,
which was a clinically beneficial result.