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Case of severe alcoholic hepatitis treated with granulocytapheresis

Severe alcoholic hepatitis (AH) has a high mortality, and it is associated with encephalopathy, acute renal failure, sepsis, gastrointestinal bleeding, and endotoxemia. The 28-d mortality remains poor (34%-40%), because no effective treatment has been established. Recently, corticosteroids (CS) have...

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Autores principales: Watanabe, Yukari, Kamimura, Kenya, Iwasaki, Tomohiro, Abe, Hiroyuki, Takahashi, Shunsaku, Mizuno, Ken-ichi, Takeuchi, Manabu, Eino, Atsushi, Narita, Ichiei, Terai, Shuji
Formato: Online Artículo Texto
Lenguaje:English
Publicado: Baishideng Publishing Group Inc 2016
Materias:
Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5112357/
https://www.ncbi.nlm.nih.gov/pubmed/27900326
http://dx.doi.org/10.12998/wjcc.v4.i11.369
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author Watanabe, Yukari
Kamimura, Kenya
Iwasaki, Tomohiro
Abe, Hiroyuki
Takahashi, Shunsaku
Mizuno, Ken-ichi
Takeuchi, Manabu
Eino, Atsushi
Narita, Ichiei
Terai, Shuji
author_facet Watanabe, Yukari
Kamimura, Kenya
Iwasaki, Tomohiro
Abe, Hiroyuki
Takahashi, Shunsaku
Mizuno, Ken-ichi
Takeuchi, Manabu
Eino, Atsushi
Narita, Ichiei
Terai, Shuji
author_sort Watanabe, Yukari
collection PubMed
description Severe alcoholic hepatitis (AH) has a high mortality, and it is associated with encephalopathy, acute renal failure, sepsis, gastrointestinal bleeding, and endotoxemia. The 28-d mortality remains poor (34%-40%), because no effective treatment has been established. Recently, corticosteroids (CS) have been considered effective for significantly improving the prognosis of those with AH, as it prevents the production of pro-inflammatory cytokines. However, CS are not always appropriate as an initial therapeutic option, such as in cases with an infection or resistance to CS. We describe a patient with severe AH complicated by a severe infection caused by the multidrug resistance bacteria (Pseudomonas aeruginosa), and was successfully treated with granulocytapheresis monotherapy without using CS. The experience of this case will provide understanding of the disease and information treating cases without using CS.
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spelling pubmed-51123572016-11-29 Case of severe alcoholic hepatitis treated with granulocytapheresis Watanabe, Yukari Kamimura, Kenya Iwasaki, Tomohiro Abe, Hiroyuki Takahashi, Shunsaku Mizuno, Ken-ichi Takeuchi, Manabu Eino, Atsushi Narita, Ichiei Terai, Shuji World J Clin Cases Case Report Severe alcoholic hepatitis (AH) has a high mortality, and it is associated with encephalopathy, acute renal failure, sepsis, gastrointestinal bleeding, and endotoxemia. The 28-d mortality remains poor (34%-40%), because no effective treatment has been established. Recently, corticosteroids (CS) have been considered effective for significantly improving the prognosis of those with AH, as it prevents the production of pro-inflammatory cytokines. However, CS are not always appropriate as an initial therapeutic option, such as in cases with an infection or resistance to CS. We describe a patient with severe AH complicated by a severe infection caused by the multidrug resistance bacteria (Pseudomonas aeruginosa), and was successfully treated with granulocytapheresis monotherapy without using CS. The experience of this case will provide understanding of the disease and information treating cases without using CS. Baishideng Publishing Group Inc 2016-11-16 2016-11-16 /pmc/articles/PMC5112357/ /pubmed/27900326 http://dx.doi.org/10.12998/wjcc.v4.i11.369 Text en ©The Author(s) 2016. Published by Baishideng Publishing Group Inc. All rights reserved. http://creativecommons.org/licenses/by-nc/4.0/ Open-Access: This article is an open-access article which was selected by an in-house editor and fully peer-reviewed by external reviewers. It is distributed in accordance with the Creative Commons Attribution Non Commercial (CC BY-NC 4.0) license, which permits others to distribute, remix, adapt, build upon this work non-commercially, and license their derivative works on different terms, provided the original work is properly cited and the use is non-commercial. See: http://creativecommons.org/licenses/by-nc/4.0/
spellingShingle Case Report
Watanabe, Yukari
Kamimura, Kenya
Iwasaki, Tomohiro
Abe, Hiroyuki
Takahashi, Shunsaku
Mizuno, Ken-ichi
Takeuchi, Manabu
Eino, Atsushi
Narita, Ichiei
Terai, Shuji
Case of severe alcoholic hepatitis treated with granulocytapheresis
title Case of severe alcoholic hepatitis treated with granulocytapheresis
title_full Case of severe alcoholic hepatitis treated with granulocytapheresis
title_fullStr Case of severe alcoholic hepatitis treated with granulocytapheresis
title_full_unstemmed Case of severe alcoholic hepatitis treated with granulocytapheresis
title_short Case of severe alcoholic hepatitis treated with granulocytapheresis
title_sort case of severe alcoholic hepatitis treated with granulocytapheresis
topic Case Report
url https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5112357/
https://www.ncbi.nlm.nih.gov/pubmed/27900326
http://dx.doi.org/10.12998/wjcc.v4.i11.369
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