title: Case of severe alcoholic hepatitis treated with granulocytapheresis.
abstract: Severe alcoholic hepatitis (AH) has a high mortality, and it is associated with encephalopathy, acute renal failure, sepsis, gastrointestinal bleeding, and endotoxemia. The 28-d mortality remains poor (34%-40%), because no effective treatment has been established. Recently, corticosteroids (CS) have been considered effective for significantly improving the prognosis of those with AH, as it prevents the production of pro-inflammatory cytokines. However, CS are not always appropriate as an initial therapeutic option, such as in cases with an infection or resistance to CS. We describe a patient with severe AH complicated by a severe infection caused by the multidrug resistance bacteria (Pseudomonas aeruginosa), and was successfully treated with granulocytapheresis monotherapy without using CS. The experience of this case will provide understanding of the disease and information treating cases without using CS.
authors.affiliation: Yukari Watanabe, Kenya Kamimura, Hiroyuki Abe, Shunsaku Takahashi, Ken-ichi Mizuno, Manabu Takeuchi, Shuji Terai, Division of Gastroenterology and Hepatology, Graduate School of Medical and Dental Sciences, Niigata University, Niigata 951-8510, Japan.
authors.forename: Yukari
authors.initials: Y
authors.lastname: Watanabe
authors.affiliation: Yukari Watanabe, Kenya Kamimura, Hiroyuki Abe, Shunsaku Takahashi, Ken-ichi Mizuno, Manabu Takeuchi, Shuji Terai, Division of Gastroenterology and Hepatology, Graduate School of Medical and Dental Sciences, Niigata University, Niigata 951-8510, Japan.
authors.forename: Kenya
authors.initials: K
authors.lastname: Kamimura
authors.affiliation: Yukari Watanabe, Kenya Kamimura, Hiroyuki Abe, Shunsaku Takahashi, Ken-ichi Mizuno, Manabu Takeuchi, Shuji Terai, Division of Gastroenterology and Hepatology, Graduate School of Medical and Dental Sciences, Niigata University, Niigata 951-8510, Japan.
authors.forename: Tomohiro
authors.initials: T
authors.lastname: Iwasaki
authors.affiliation: Yukari Watanabe, Kenya Kamimura, Hiroyuki Abe, Shunsaku Takahashi, Ken-ichi Mizuno, Manabu Takeuchi, Shuji Terai, Division of Gastroenterology and Hepatology, Graduate School of Medical and Dental Sciences, Niigata University, Niigata 951-8510, Japan.
authors.forename: Hiroyuki
authors.initials: H
authors.lastname: Abe
authors.affiliation: Yukari Watanabe, Kenya Kamimura, Hiroyuki Abe, Shunsaku Takahashi, Ken-ichi Mizuno, Manabu Takeuchi, Shuji Terai, Division of Gastroenterology and Hepatology, Graduate School of Medical and Dental Sciences, Niigata University, Niigata 951-8510, Japan.
authors.forename: Shunsaku
authors.initials: S
authors.lastname: Takahashi
authors.affiliation: Yukari Watanabe, Kenya Kamimura, Hiroyuki Abe, Shunsaku Takahashi, Ken-ichi Mizuno, Manabu Takeuchi, Shuji Terai, Division of Gastroenterology and Hepatology, Graduate School of Medical and Dental Sciences, Niigata University, Niigata 951-8510, Japan.
authors.forename: Ken-Ichi
authors.initials: KI
authors.lastname: Mizuno
authors.affiliation: Yukari Watanabe, Kenya Kamimura, Hiroyuki Abe, Shunsaku Takahashi, Ken-ichi Mizuno, Manabu Takeuchi, Shuji Terai, Division of Gastroenterology and Hepatology, Graduate School of Medical and Dental Sciences, Niigata University, Niigata 951-8510, Japan.
authors.forename: Manabu
authors.initials: M
authors.lastname: Takeuchi
authors.affiliation: Yukari Watanabe, Kenya Kamimura, Hiroyuki Abe, Shunsaku Takahashi, Ken-ichi Mizuno, Manabu Takeuchi, Shuji Terai, Division of Gastroenterology and Hepatology, Graduate School of Medical and Dental Sciences, Niigata University, Niigata 951-8510, Japan.
authors.forename: Atsushi
authors.initials: A
authors.lastname: Eino
authors.affiliation: Yukari Watanabe, Kenya Kamimura, Hiroyuki Abe, Shunsaku Takahashi, Ken-ichi Mizuno, Manabu Takeuchi, Shuji Terai, Division of Gastroenterology and Hepatology, Graduate School of Medical and Dental Sciences, Niigata University, Niigata 951-8510, Japan.
authors.forename: Ichiei
authors.initials: I
authors.lastname: Narita
authors.affiliation: Yukari Watanabe, Kenya Kamimura, Hiroyuki Abe, Shunsaku Takahashi, Ken-ichi Mizuno, Manabu Takeuchi, Shuji Terai, Division of Gastroenterology and Hepatology, Graduate School of Medical and Dental Sciences, Niigata University, Niigata 951-8510, Japan.
authors.forename: Shuji
authors.initials: S
authors.lastname: Terai
keywords: Alcoholic; Alcoholic hepatitis; Apheresis; Case reports; Hepatitis