Veno-occlusive disease of the liver after chemotherapy for acute lymphoblastic leukemia: A case report

Abstract

The veno-occlusive disease (VOD) of the liver is a disorder caused by the non-thrombotic occlusion of the central veins of hepatic lobules. In this report, we describe a case of a seven-years-old boy who did not have preexisting liver disease and developed veno-occlusive disease of the liver while receiving chemotherapy for acute lymphoblastic leukemia. He was treated according to modified ALL BFM 95 protocol. He exhibited a sudden weight gain, abdominal pain, ascites, edema, hepatomegaly and fever in protocol II. There was rapid worsening of symptoms with elevation of liver enzymes, thrombocytopenia and respiratory failure due to ascites. Doppler sonography was not suggestive of diagnosis but the liver biopsy sample correlated with acute VOD. After receiving supportive treatment he recovered completely. As a result, veno-occlusive disease of the liver should be considered in children who develop weight gain, a sudden drop in platelet count with derangement of liver enzymes while receiving chemotherapy.