A case of autoimmune hepatitis showing resistance to a steroid and immunosuppressants

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  • Kozuka Ritsuzo
    Department of hepatology, Osaka City University Graduate School of Medicine
  • Iwai Shuji
    Department of hepatology, Osaka City University Graduate School of Medicine
  • Toyama Madoka
    Department of hepatology, Osaka City University Graduate School of Medicine
  • Fujii Hideki
    Department of hepatology, Osaka City University Graduate School of Medicine
  • Yasuda Takahiro
    Department of hepatology, Osaka City University Graduate School of Medicine
  • Kobayashi Sawako
    Department of hepatology, Osaka City University Graduate School of Medicine
  • Kurooka Hiroko
    Department of hepatology, Osaka City University Graduate School of Medicine
  • Nakayama Yuji
    Department of hepatology, Osaka City University Graduate School of Medicine
  • Enomoto Masaru
    Department of hepatology, Osaka City University Graduate School of Medicine
  • Morikawa Hiroyasu
    Department of hepatology, Osaka City University Graduate School of Medicine
  • Tamori Akihiro
    Department of hepatology, Osaka City University Graduate School of Medicine
  • Sakaguchi Hiroki
    Department of hepatology, Osaka City University Graduate School of Medicine
  • Kawada Norifumi
    Department of hepatology, Osaka City University Graduate School of Medicine

Bibliographic Information

Other Title
  • 各種治療に抵抗性を示した自己免疫性肝炎の１例
  • 症例報告 各種治療に抵抗性を示した自己免疫性肝炎の1例
  • ショウレイ ホウコク カクシュ チリョウ ニ テイコウセイ オ シメシタ ジコ メンエキセイ カンエン ノ 1レイ

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Description

A 27-year-old woman consulted a doctor with nasal congestion. At that time, a high level of γ-globulin and IgG was observed in her blood test. Afterwards, she was admitted to our hospital because of a high level of serum transaminases. We diagnosed her disease as autoimmune hepatitis following the results of several serum tests and the liver histopathology obtained by liver biopsy. She was initially treated with prednisolone (PSL) 30 mg/day. Because we found that the steroid treatment was insufficient, we further added azathioprine (AZA) 50 mg/day to the steroid. Use of AZA showed some effect. However, the hepatopathy did not improve and the medication was changed to cyclosporine (CYA) because agranulocytosis was observed as a side effect. The patient died following a sudden decline of consciousness and acute respiratory failure due to a pneumocystis carinii infection. We here report a case that showed resistance to treatment using a steroid, AZA, and CYA.<br>

Journal

  • Kanzo

    Kanzo 50 (5), 223-228, 2009

    The Japan Society of Hepatology

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