Vanishing Bile Duct Syndrome as an Uncommon Hepatic Paraneoplastic Syndrome in Hodgkin’s Lymphoma

TL;DR

Vanishing bile duct syndrome is a rare liver condition that can occur as a paraneoplastic syndrome in Hodgkin’s lymphoma and may improve with chemotherapy.

Contribution

This case report highlights VBDS as an uncommon paraneoplastic manifestation of Hodgkin’s lymphoma.

Findings

A 53-year-old female with Hodgkin’s lymphoma presented with symptoms of vanishing bile duct syndrome.

Chemotherapy led to normalization of symptoms and liver function tests in the patient.

Liver biopsy and imaging confirmed the diagnosis of VBDS and HL.

Abstract

Vanishing bile duct syndrome (VBDS) is a rare form of liver injury caused by ischemia, drug reactions, autoimmune diseases, infections, or malignancy. VBDS involves the progressive disappearance of intrahepatic bile ducts, causing cholestasis and biliary cirrhosis, with high mortality if untreated. VBDS can also present as a paraneoplastic syndrome in Hodgkin’s lymphoma (HL). A 53‐year‐old female presented with jaundice, pruritus, diarrhea, and elevated liver function tests (LFTs). A liver biopsy demonstrated cholestasis with mild ductopenia, and imaging revealed enlarged para‐aortic lymph nodes. A bone marrow biopsy confirmed HL, and chemotherapy normalized symptoms and LFTs.

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