Severe Alcoholic Hepatitis with Extremely High Neutrophil Count Successfully Treated by Granulocytapheresis
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概要
- 論文の詳細を見る
We report a severe alcoholic hepatitis (SAH) patient with an extremely high WBC count, high serum bilirubin and low prothrombin time (PT) successfully treated with granulocytapheresis. After neutrophilelastase inhibitor failed to reduce WBC count, methylprednisolone pulse therapy was performed. However, WBC count continued to be elevated to 97,190 /μl (neutrophils 97.0%) despite improvement of total bilirubin and PT. After 5 sessions of granulocytapheresis and ulinastatin administration, increased serum IL6, IL8, neutrophilelastase and WBC count gradually decreased. We could conclude that granulocytapheresis and ulinastatin can be very effective in reducing cytokines and neutrophilelastase, and in improving the general status of SAH patients.
著者
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Tanaka Eiji
Department Of Digestion And Cardiovascular Medicine University Of Tokushima
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Kiyosawa Kendo
Department Of Gastroenterology Shinshu University School Of Medicine
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Muto Hidetomo
Department of Internal Medicine, Inagi Municipal Hospital
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Hora Kazuhiko
Division Of Artificial Kidney Shinshu University School Of Medicine
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Umemura Takeji
Department Of Gastroenterology Shinshu University School Of Medicine
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Yoshizawa Kaname
Department Of Gastroenterology Shinshu University School Of Medicine
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Ichijo Tetsuya
Department Of Gastroenterology Shinshu University School Of Medicine
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Matsumoto Akihiko
Department Of 1st Surgery Yokohama City University School Of Medicine
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Okiyama Wataru
Department of Internal Medicine/Gastroenterology, Shinshu University School of Medicine
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Okubo Kentaro
Department of Nephrology, Aizawa Hospital
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Hora Kazuhiko
Division of Blood Purification, Shinshu University Hospital
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Muto Hidetomo
Department of Medicine, Shinshu University School of Medicine
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Kontani Kayoko
Department of Medicine, Shinshu University School of Medicine
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Shimodaira Sigetaka
Division of Blood Transfusion Medicine, Shinshu University Hospital
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