Digestive Diseases and Sciences

, Volume 59, Issue 2, pp 482–488

Granulocytapheresis for the Treatment of Severe Alcoholic Hepatitis: A Case Series and Literature Review

Authors

    • Division of Gastroenterology and Hepatology, Graduate School of Medical and Dental SciencesNiigata University
  • Michitaka Imai
    • Division of Gastroenterology and Hepatology, Graduate School of Medical and Dental SciencesNiigata University
  • Akira Sakamaki
    • Division of Gastroenterology and Hepatology, Graduate School of Medical and Dental SciencesNiigata University
  • Shigeki Mori
    • Department of Gastroenterology and HepatologyShinrakuen Hospital
  • Masaaki Kobayashi
    • Division of Gastroenterology and Hepatology, Graduate School of Medical and Dental SciencesNiigata University
  • Ken-ichi Mizuno
    • Division of Gastroenterology and Hepatology, Graduate School of Medical and Dental SciencesNiigata University
  • Manabu Takeuchi
    • Division of Gastroenterology and Hepatology, Graduate School of Medical and Dental SciencesNiigata University
  • Takeshi Suda
    • Division of Gastroenterology and Hepatology, Graduate School of Medical and Dental SciencesNiigata University
  • Minoru Nomoto
    • Division of Gastroenterology and Hepatology, Graduate School of Medical and Dental SciencesNiigata University
  • Yutaka Aoyagi
    • Division of Gastroenterology and Hepatology, Graduate School of Medical and Dental SciencesNiigata University
Case Report

DOI: 10.1007/s10620-013-2871-y

Cite this article as:
Kamimura, K., Imai, M., Sakamaki, A. et al. Dig Dis Sci (2014) 59: 482. doi:10.1007/s10620-013-2871-y

Abstract

Severe alcoholic hepatitis has a high mortality rate due to limited therapeutic methods. Although corticosteroids have been used to control the inflammatory response, the outcomes vary and no standardized therapy has been established. Novel therapeutic approaches, such as anti-TNF-α, pentoxifilline, and others have been tested clinically on the basis of their cytokinemic pathophysiology with limited success. However, treatment of leukocytosis that causes cytokinemia and hepatic inflammation in patients via granulocytapheresis and leukocytapheresis showed promising results in a number of reports. Here, we report two cases of severe alcoholic hepatitis treated with granulocytapheresis. The liver function and inflammation recovered after the therapy. A review of 35 cases treated with granulocytapheresis and leukocytapheresis demonstrated their efficacy in treating alcoholic hepatitis by controlling leukocytosis as well as cytokines such as IL-8. Multidisciplinary treatment for severe alcoholic hepatitis should be considered case by case on the basis of the complexity and severity of the condition.

Keywords

Severe alcoholic hepatitisGranulocytapheresisLeukocytapheresisIL-6IL-8

Copyright information

© Springer Science+Business Media New York 2013