Severe alcoholic hepatitis with extremely high neutrophil count successfully treated by granulocytapheresis.
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.
Okubo
Kentaro
K
Department of Medicine, Shinshu University School of Medicine, Matsumoto.
Yoshizawa
Kaname
K
Okiyama
Wataru
W
Kontani
Kayoko
K
Muto
Hidetomo
H
Umemura
Takeji
T
Ichijo
Tetsuya
T
Matsumoto
Akihiko
A
Tanaka
Eiji
E
Hora
Kazuhiko
K
Shimodaira
Sigetaka
S
Kiyosawa
Kendo
K
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
D006023:Glycoproteins; D014361:Trypsin Inhibitors; C028665:urinastatin