Case report, case study

https://doi.org/10.21860/medflum2024_319220

Recompensation of Decompensated Liver Cirrhosis with Newly Diagnosed Chronic Myeloproliferative Disease and the Issue of Giving Up Liver Transplantation – a Case Report

Iva Saraja orcid.org/0009-0003-1341-2987 ; Sveučilište u Rijeci, Medicinski fakultet, Rijeka, Hrvatska *
Goran Hauser ; Sveučilište u Rijeci, Medicinski fakultet, Rijeka, Hrvatska; Klinički bolnički centar Rijeka, Klinika za internu medicinu, Zavod za gastroenterologiju, Rijeka, Hrvatska

* Corresponding author.

Abstract

Aim: To present an exceptional and rare medical turnaround in which decompensated cirrhosis of the liver moved into the compensated phase, with an emphasis on significant improvement in the state of cirrhosis that eliminated the need for liver transplantation, in the presence of an underlying myeloproliferative disease. Case report: A 63-year-old female patient was admitted to the Institute of Gastroenterology at clinical hospital centre Rijeka (KBC Rijeka) due to the presence of ascites of unknown aetiology. During the following period (2018-2022), she was hospitalized three times. After detailed clinical and serological analyses, a diagnosis of alcoholic liver cirrhosis was made. Although the preliminary preparation for orthotopic liver transplantation was started, the procedure was abandoned due to detected active hepatitis A infection and non-adherence to the prescribed therapy. Due to the intensification of the disease, the patient developed oedema of the extremities, fluctuations in body weight and jaundice. Regular paracentesis, with the addition of 20% human albumin, was necessary. The patient continuously consumed alcohol, and adherence to the prescribed therapy was also inconsistent. In 2021, she was diagnosed with polycythaemia rubra vera, which further complicated her condition. However, at the end of 2022, an improvement in laboratory findings and clinical picture was observed, which resulted in the transition from the decompensated phase of liver cirrhosis to the compensated phase. The reason for this reversal is assumed to be a consequence of consistent adherence to the prescribed therapy and abstinence from alcohol. Conclusion: This case confirms that decompensated alcoholic liver cirrhosis does not necessarily lead to the terminal stage of the disease. Through strict adherence to therapy, regular check-ups and abstinence from alcohol, there is a possibility of a significant improvement in the patient's condition to the extent that a liver transplant is no longer necessary. In addition, this case highlights the importance of an integrated multidisciplinary approach in patients with liver cirrhosis and associated myeloproliferative disease as an important predictor of disease course and outcome.

Keywords

alcoholism; liver cirrhosis; liver transplantation; neoplasms; polycythaemia vera

Hrčak ID:

319220

URI

https://hrcak.srce.hr/319220

Publication date:

1.9.2024.

Article data in other languages: croatian

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