TY - JOUR
T1 - Rescue therapy by portal infusion of autologous stem cells in a case of drug-induced hepatitis
AU - Gasbarrini, Antonio
AU - Zocco, Maria Assunta
AU - Rutella, Sergio
AU - Tittoto, Paola
AU - Leone, Giuseppe
AU - Pola, Paolo
AU - Gasbarrini, Giovanni Battista
AU - Di Campli, Cristiana
AU - 33183,
AU - FACOLTA', DI MEDICINA E CHIRURGIA "A.GEMELLI"
AU - traslazionale, ROMA - Dipartimento di Medicina e chirurgia
AU - Rapaccini, Gl
PY - 2007
Y1 - 2007
N2 - Recent efforts have been directed toward new therapeutic options to approach drug-induced hepatitis. We report a case of acute liver failure associated with Nimesulide in a 67-year-old man, with a medical history of chronic alcohol abuse. The biopsy was compatible with chronic alcoholic liver disease and acute drug-induced injury. The patient was enrolled to receive G-CSF followed by apheresis and selection of peripheral-blood stem cells. After ultrasound-guided injection of CD34+cells in the portal vein, we observed a rapid improvement of synthetic liver function, with particular reference to coagulation parameters. Liver biopsy performed 20 days after, showed wide areas of regeneration. In the next 30 days the laboratory signs of acute decompensation progressively improved. Unfortunately he died of multiple-organ failure related to bacterial infection. Intrahepatic injection of peripheral-blood stem cells seemed safe and produced good periprocedural results with improvement of synthetic profile, suggesting a possible role of stem cells in the regeneration process.
AB - Recent efforts have been directed toward new therapeutic options to approach drug-induced hepatitis. We report a case of acute liver failure associated with Nimesulide in a 67-year-old man, with a medical history of chronic alcohol abuse. The biopsy was compatible with chronic alcoholic liver disease and acute drug-induced injury. The patient was enrolled to receive G-CSF followed by apheresis and selection of peripheral-blood stem cells. After ultrasound-guided injection of CD34+cells in the portal vein, we observed a rapid improvement of synthetic liver function, with particular reference to coagulation parameters. Liver biopsy performed 20 days after, showed wide areas of regeneration. In the next 30 days the laboratory signs of acute decompensation progressively improved. Unfortunately he died of multiple-organ failure related to bacterial infection. Intrahepatic injection of peripheral-blood stem cells seemed safe and produced good periprocedural results with improvement of synthetic profile, suggesting a possible role of stem cells in the regeneration process.
KW - Aged
KW - Anti-Inflammatory Agents, Non-Steroidal
KW - Drug-Induced Liver Injury
KW - Humans
KW - Liver Failure
KW - Liver Regeneration
KW - Male
KW - Peripheral Blood Stem Cell Transplantation
KW - Sulfonamides
KW - Transplantation, Autologous
KW - Treatment Outcome
KW - Aged
KW - Anti-Inflammatory Agents, Non-Steroidal
KW - Drug-Induced Liver Injury
KW - Humans
KW - Liver Failure
KW - Liver Regeneration
KW - Male
KW - Peripheral Blood Stem Cell Transplantation
KW - Sulfonamides
KW - Transplantation, Autologous
KW - Treatment Outcome
UR - http://hdl.handle.net/10807/24023
U2 - 10.1016/j.dld.2006.06.037
DO - 10.1016/j.dld.2006.06.037
M3 - Article
VL - 39
SP - 878
EP - 882
JO - DIGESTIVE AND LIVER DISEASE
JF - DIGESTIVE AND LIVER DISEASE
SN - 1590-8658
ER -