Therapeutic strategies for severe alcoholic hepatitis

Yoshinori Horie, Yoshiyuki Yamagishi, Hirotoshi Ebinuma, Toshifumi Hibi

研究成果: Article査読

15 被引用数 (Scopus)

抄録

Background and aims: Severe alcoholic hepatitis (SAH) is an inflammatory response with multiple morbidity factors like leucocytosis, hepatomegaly, renal failure, hepatic encephalopathy, endotoxemia, and has a high mortality rate. Accordingly, identifying therapeutic interventions that can support prognosis is the goal of research. Methods: Questionnaires were sent to 1234 medical institutions asking for information on patients with SAH during 2004 to 2008 including patients' demography, disease profile and the therapeutic interventions patients had received during hospitalization. Results: Twenty-nine hospitals had treated SAH patients, and provided full demographic data on 62 patients. Twenty-seven patients had received no treatment, 10 patients had received granulocytes/monocytes apheresis (GMA) to deplete elevated myeloid linage leucocytes, the rest had received one or more of the following treatments, corticosteroids, plasma exchange (PE) and haemodialysis (HD). Further, 23 patients had died and 39 had survived within 100 days of hospitalization. Serum creatinine (Cr) was higher in patients who had died vs patients who had survived (P=0.026). Likewise, patients with white blood cells (WBC)≥10 4/μL had higher mortality rate vs patients with WBC<10 4/μL (P=0.039). GMA in patients with WBC≥10 4/μL showed 100% prognosis vs patients with WBC≥10 4/μL who did not receive GMA (P=0.0007). Corticosteroids, PE and HD did not significantly impact prognosis of SAH patients. Conclusions: Our perception is that, patients with elevated myeloid leucocytes benefit most from GMA, while PE appears to support patients with coagulation deficiency or high plasma bilirubin and HD has indication in patients with high Cr.

本文言語English
ページ(範囲)738-744
ページ数7
ジャーナルClinics and Research in Hepatology and Gastroenterology
35
11
DOI
出版ステータスPublished - 2011 11月

ASJC Scopus subject areas

  • 肝臓学
  • 消化器病学

フィンガープリント

「Therapeutic strategies for severe alcoholic hepatitis」の研究トピックを掘り下げます。これらがまとまってユニークなフィンガープリントを構成します。

引用スタイル