Case report

BMC Blood Disorders

, 12:8

First online:

Open Access This content is freely available online to anyone, anywhere at any time.

Syncytial giant cell hepatitis associated with chronic lymphocytic leukemia: a case report

  • Eva GuptaAffiliated withDepartment of Medicine, St John Hospital and Medical Center
  • , Michael YacoubAffiliated withDepartment of Medicine, St John Hospital and Medical Center
  • , Martha HigginsAffiliated withDepartment of Pathology, St John Hospital and Medical Center
  • , Ayad M Al-KatibAffiliated withDepartment of Medicine, St John Hospital and Medical CenterVan Elslander Cancer Center, St John Hospital and Medical Center Email author 



Syncytial giant cell hepatitis (GCH) is an uncommon and an underreported disease entity. In two previously reported cases of GCH in patients with Chronic Lymphocytic Leukemia (CLL) liver failure ensued. Autoimmune and infective causes have been implicated but its etiology remains unclear.

Case Presentation

A 60-year-old female with CLL presented with acute hepatitis with negative viral and auto-immune serologies and without any prior toxic exposure. Liver biopsy showed typical histological features of GCH. The patient was successfully treated with corticosteroids and intravenous immunoglobulin (IVIG). Her liver enzymes returned to baseline and have remained normal as of the last follow up almost 4 years later.


Association of GCH with CLL may be under recognized. Clinical suspicion of GCH in CLL patients with serology-negative hepatitis, early liver biopsy and therapeutic intervention may influence outcome. This is the first case report of successful treatment of GCH in CLL patients. Moreover, our case also demonstrates the ability to resume effective CLL therapy post-GCH diagnosis without detriment to the liver.