Interleukin 18 and hepatocyte growth factor in fulminant hepatic failure of adult onset Still's disease.
Adult onset Still's disease (AOSD) is a rheumatoid disorder characterized by polyarthritis, intermittent high fever, and salmon colored rashes. Liver dysfunction is usually mild and fulminant liver failure is rare. We describe a 20-year-old woman with AOSD and severe hepatic necrosis leading to hepatic failure requiring liver transplant. This severe liver disorder developed after decreases in fever, arthritis, and C-reactive protein. Interleukin 18 (IL-18), but not ferritin, increased in association with liver dysfunction. Hepatocyte growth factor (HGF) increased at the time of hepatic failure. IL-18 and HGF elevation may have contributed to this rare severe liver injury in AOSD.
Division of Clinical Immunology, Department of Internal Medicine, Hyogo College of Medicine, Hyogo, Japan. a-ogata@hyo-med.ac.jp
Atsushi
A
Ogata
Masayasu
M
Kitano
Jyunichi
J
Yamanaka
Tomoko
T
Yamasaki
Naoaki
N
Hashimoto
Tsuyoshi
T
Iwasaki
Teruaki
T
Hamano
Jiro
J
Fujimoto
Eizo
E
Kakishita
D000328:Adult; D005260:Female; D017228:Hepatocyte Growth Factor / Q000097:blood*; D006801:Humans; D020382:Interleukin-18 / Q000097:blood*; D017093:Liver Failure / Q000097:blood* / Q000209:etiology / Q000601:surgery; D016031:Liver Transplantation; D016706:Still's Disease, Adult-Onset / Q000097:blood* / Q000150:complications
D020382:Interleukin-18; D017228:Hepatocyte Growth Factor