title: Severe alcoholic hepatitis with extremely high neutrophil count successfully treated by granulocytapheresis.
abstract: 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 neutrophil-elastase inhibitor failed to reduce WBC count, methylprednisolone pulse therapy was performed. However, WBC count continued to be elevated to 97,190/microl (neutrophils 97.0%) despite improvement of total bilirubin and PT. After 5 sessions of granulocytapheresis and ulinastatin administration, increased serum IL-6, IL-8, neutrophil-elastase and WBC count gradually decreased. We could conclude that granulocytapheresis and ulinastatin can be very effective in reducing cytokines and neutrophil-elastase, and in improving the general status of SAH patients.
authors.affiliation: Department of Medicine, Shinshu University School of Medicine, Matsumoto.
authors.forename: Kentaro
authors.initials: K
authors.lastname: Okubo
authors.forename: Kaname
authors.initials: K
authors.lastname: Yoshizawa
authors.forename: Wataru
authors.initials: W
authors.lastname: Okiyama
authors.forename: Kayoko
authors.initials: K
authors.lastname: Kontani
authors.forename: Hidetomo
authors.initials: H
authors.lastname: Muto
authors.forename: Takeji
authors.initials: T
authors.lastname: Umemura
authors.forename: Tetsuya
authors.initials: T
authors.lastname: Ichijo
authors.forename: Akihiko
authors.initials: A
authors.lastname: Matsumoto
authors.forename: Eiji
authors.initials: E
authors.lastname: Tanaka
authors.forename: Kazuhiko
authors.initials: K
authors.lastname: Hora
authors.forename: Sigetaka
authors.initials: S
authors.lastname: Shimodaira
authors.forename: Kendo
authors.initials: K
authors.lastname: Kiyosawa
mesh_terms: D000328:Adult; D005260:Female; D006023:Glycoproteins / Q000627:therapeutic use; D006098:Granulocytes; D006519:Hepatitis, Alcoholic / Q000097:blood / Q000628:therapy*; D006801:Humans; D007937:Leukapheresis; D007958:Leukocyte Count; D014361:Trypsin Inhibitors / Q000627:therapeutic use
chemical_list: D006023:Glycoproteins; D014361:Trypsin Inhibitors; C028665:urinastatin