Case of severe alcoholic hepatitis treated with granulocytapheresis
Case of severe alcoholic hepatitis treated with granulocytapheresis
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DOI：
10.12998/wjcc.v4.i11.369
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发表时间：
2016-11-16
影响因子：
1.1
通讯作者：
Terai, Shuji
中科院分区：
文献类型：
--
作者：
Watanabe, Yukari;Kamimura, Kenya;Terai, Shuji
重型酒精性肝炎（AH）死亡率高，并与脑病、急性肾功能衰竭、脓毒症、消化道出血和内毒素血症有关。28天死亡率仍然很低（34%-40%），因为没有有效的治疗方法。最近，皮质类固醇（CS）已被认为是有效的显着改善与AH的预后，因为它可以防止促炎细胞因子的产生。然而，CS并不总是适合作为初始治疗选择，例如在感染或对CS耐药的情况下。我们描述了一个严重的AH并发多重耐药菌（铜绿假单胞菌）引起的严重感染的患者，并成功地治疗粒细胞单药治疗，而不使用CS。该病例的经验将提供对疾病的理解和不使用CS治疗病例的信息。
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.