PMC9167125_01
H&E stain (200x) showing marked canalicular cholestasis, portal and periportal fibrosis, bile duct injury, ductular reaction, and portal and lobular neutrophilic infiltrates, most suggestive of biliary obstruction.
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fig1
Given worsening hyperbilirubinemia, a liver biopsy was subsequently pursued which was suggestive of a nonspecific cholestatic liver injury (Figures 1-3).
H&E stain (200x) showing marked canalicular cholestasis, portal and periportal fibrosis, bile duct injury, ductular reaction, and portal and lobular neutrophilic infiltrates, most suggestive of biliary obstruction.
CRIHEP2022-9630996.002.jpg
PMC9167125_01_CRIHEP2022-9630996.002.jpg
fig2
Given worsening hyperbilirubinemia, a liver biopsy was subsequently pursued which was suggestive of a nonspecific cholestatic liver injury (Figures 1-3).
Trichrome stain (40x) showing portal and periportal fibrosis, as well as focal sinusoidal collagen deposition.
CRIHEP2022-9630996.003.jpg
PMC9167125_01_CRIHEP2022-9630996.003.jpg
fig3
Given worsening hyperbilirubinemia, a liver biopsy was subsequently pursued which was suggestive of a nonspecific cholestatic liver injury (Figures 1-3).
Total bilirubin trends with relation to initiation and discontinuation of ruxolitinib.
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fig4
TB to 17 mg/dL (Figure 4). The patient's course was unfortunately complicated by renal failure secondary to biopsy-confirmed bile-acid nephropathy, ascites, functional decline, and eventually was transitioned to hospice.