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CASE REPORT
Acute myeloid leukaemia: an unusual cause of biliary strictures
  1. Adele Beck1,
  2. Hannah Hunter2,
  3. Simon Jackson3 and
  4. David Sheridan1,4
  1. 1 University Hospitals Plymouth NHS Trust, Plymouth, UK
  2. 2 Department of Haematology, University Hospitals Plymouth NHS Trust, Plymouth, UK
  3. 3 Department of Radiology, University Hospitals Plymouth NHS Trust, Plymouth, UK
  4. 4 Faculty of Medicine & Dentistry, University of Plymouth, Plymouth, UK
  1. Correspondence to Dr David Sheridan, david.sheridan{at}plymouth.ac.uk

Abstract

A 17-year-old man with no significant past medical history presented with a 2-week history of worsening jaundice, lethargy, anorexia and progressive right upper quadrant abdominal pain. There were no stigmata of chronic liver disease. Initial investigations were suggestive of cholangitis with large intrahepatic and extrahepatic bile duct strictures but otherwise normal hepatic and splenic appearances. A percutaneous transhepatic cholangiogram with the positioning of drains was performed to alleviate the obstructive jaundice. Within 2 weeks of the first presentation, full blood count revealed a significantly raised white blood count and a subsequent peripheral blood smear and bone marrow were consistent with a diagnosis of acute myeloid leukaemia. Chemotherapy was started after partial improvement of his obstructive jaundice. Complete morphological and cytogenetic remission was obtained 4 weeks after the first cycle of chemotherapy (half dose of daunorubicin and full dose of cytarabine, treated off trial) on control bone marrow. The patient remains in remission.

  • liver disease
  • pancreas and biliary tract
  • radiology
  • malignant and benign haematology

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Footnotes

  • Contributors AB acquired the clinical data and wrote the first draft of the report. HH interpreted the blood film and bone marrow data, provided clinical data and interpretation of findings. SJ provided the diagnostic and interventional radiology data and interpretation. DS conceived the report, wrote the final draft, provided interpretation of findings and literature review. All authors approved the final report.

  • Funding The authors have not declared a specific grant for this research from any funding agency in the public, commercial or not-for-profit sectors.

  • Competing interests None declared.

  • Provenance and peer review Not commissioned; externally peer reviewed

  • Patient consent for publication Obtained.

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