Clin Mol Hepatol.  2018 Dec;24(4):430-435. 10.3350/cmh.2017.0016.

Favorable effect of corticosteroids in treating acute-on-chronic liver failure underlying chronic hepatitis B

Affiliations
  • 1Department of Internal Medicine, The Catholic University of Korea Incheon St. Mary's Hospital, Incheon, Korea. doctorkwon@catholic.ac.kr
  • 2Department of Internal Medicine, The Catholic University of Korea Seoul St. Mary's Hospital, Seoul, Korea.

Abstract

Acute-on-chronic liver failure (ACLF) occurs in the presence of a chronic liver disease or cirrhosis, and often results from exacerbation of chronic hepatitis B (CHB). The efficacy of corticosteroid treatment in ACLF patients with underlying CHB remains unclear. We report the case of a 50-year-old woman who experienced ACLF due to CHB exacerbation and was treated with a combination of corticosteroids and nucleot(s)ide analogue (NUC). The patient showed rapid decompensation due to CHB exacerbation. Three months of antiviral therapy produced no improvement in liver function. Combination therapy with corticosteroids and NUC was started, which did result in improvement of liver function. This case shows that the combined therapy of corticosteroids and NUC can be effective in treating ACLF due to CHB exacerbation.

Keyword

Acute-on-chronic liver failure; Chronic hepatitis B; Corticosteroid; Exacerbation; Reactivation

MeSH Terms

Acute-On-Chronic Liver Failure*
Adrenal Cortex Hormones*
Female
Fibrosis
Hepatitis B, Chronic*
Hepatitis, Chronic*
Humans
Liver
Liver Diseases
Middle Aged
Adrenal Cortex Hormones
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