Isolated hyperbilirubinemia as the manifestation of acute liver failure in a patient with acute myelogenous leukemia and COVID-19 infection

Acute liver failure is a rare but catastrophic syndrome. Liver function tests usually reveal cholestatic or hepatocellular pattern, but in this case, we report a previously undescribed manifestation of this condition as isolated hyperbilirubinemia. Our patient was a 50 years old male who was diagnosed with acute myelogenous leukemia (AML(M4)). The patient had no history of liver disease and had normal liver function tests at the time of admission. After chemotherapy treatment, the patient developed signs of acute liver failure and had a rapid demise. After further investigations, we found two possible causes. Firstly, liver involvement of acute myelogenous leukemia (AML) which after induction chemotherapy is a rare condition and has high mortality rates despite treatment. Secondly, acute liver injury due to COVID-19 infection.