Abstract
Vanishing bile duct syndrome (VBDS) is an acquired condition of progressive intrahepatic bile duct loss, resulting in severe cholestasis. Here, we present a case of VBDS in a patient with newly diagnosed classic Hodgkin's lymphoma (cHL). Our patient presented with cholestatic liver test elevations, including bilirubin and alkaline phosphatase. Liver biopsy confirmed the paucity of bile ducts and did not show involvement by lymphoma. Though the exact pathophysiology is unclear, it is postulated to be driven by cytokine release and T-lymphocyte cell dysregulation. Our patient has made a remarkable, albeit incomplete, liver recovery with cHL-directed treatment. Given the poor prognosis and higher mortality rate of VBDS, a multidisciplinary approach involving oncology, hepatology, and prompt initiation of dose-adjusted chemotherapy is imperative.