SAGAWA Takaomi
   Department   School of Medicine(Tokyo Women's Medical University Hospital), School of Medicine
   Position   Assistant Professor
Article types Case report
Language English
Peer review Non peer reviewed
Title The utility of liver transplantation to treat acute liver failure caused by adult-onset Still's disease: case reports.
Journal Formal name:Clinical journal of gastroenterology
Abbreviation:Clin J Gastroenterol
ISSN code:18657265/18657265
Domestic / ForeginDomestic
Volume, Issue, Page 14(3),pp.866-875
Author and coauthor OGASAWARA Yuri, KOGISO Tomomi, KOTERA Yoshihito, OMORI Akiko, KONDA Naoko, SUGANO Eri, SAGAWA Takaomi, TANIAI Makiko, HARIGAI MASAYOSHI, YAMAMOTO Masakazu, TOKUSHIGE Katsutoshi
Publication date 2021/06
Summary PURPOSE:Adult-onset Still's disease (AOSD) is an inflammatory condition commonly complicated by mild liver dysfunction. However, severe liver failure is rarely reported. We report three cases of severe acute hepatic failure (ALF) associated with AOSD. We encountered three cases of acute liver failure (ALF) with encephalopathy.RESULTS:Case 1 was a 75-year-old female, who was started on a steroid (prednisolone, PSL) to treat AOSD; this was gradually tapered. Two months later, severe ALF developed. She died despite an increase in the PSL dose and artificial liver support. Case 2 was a 26-year-old-female taking PSL 30 mg/day to treat subacute thyroiditis. PSL was tapered, and she received methyl PSL pulse therapy and artificial liver support, but this did not cure the ALF. Liver transplantation (LT) was performed 25 days later. Three years later, the same symptoms were observed and we diagnosed AOSD. Case 3 was a 56-year-old-female who met the AOSD criteria. PSL 50 mg/day was started and then tapered. Methyl PSL pulse therapy was prescribed to treat hemophagocytic syndrome, but she required LT on hospital day 13.CONCLUSION:In AOSD cases, ALF is rarely complicated; urgent LT should be considered only for patients with AOSD-related severe ALF.
DOI 10.1007/s12328-021-01398-3
PMID 33797038