A 10 Years Old Girl with Isolated Hepatitis (Fulminant Liver Failure) was Incidentally Found to Have B-Cell Leukemia Evident in Liver Histopathology

Abstract

A young girl who was previously healthy with no evidence of systemic illness but rather sudden onset of abdominal pain, jaundice and fever was evaluated as hepatitis for investigation and management. Main differential was viral hepatitis among others, as the most common reasons of acute liver failure. However, the initial investigations ruled out infectious sources, drug induced causes of the disease, and chronic liver diseases. Thus, as hepatitis with impending liver failure of unknown source, liver biopsy was performed. Surprisingly, results were persistent with leukemia. This child was an extraordinary case that presented as liver case initially, however ended up being a systemic illness, malignancy, causing secondary liver failure. Upon reviewing records, all children either manifested early on or later with hepatitis, have other signs of malignancy which were evident with initial presentation to consider malignancy as a source.