A case of chronic active hepatitis type B with severe liver dysfunction induced by steroid withdrawal therapy / 日本農村医学会雑誌

ABSTRACT

It was reported that steroid withdrawal therapy was beneficial in the management of patients with HBsAg-positive chronic active hepatitis and rarely led to fulminant hepatitis. We report a caseof chronic active hepatitis type B who developed severe liver dysfunction by steroid withdrawal therapy, and died one month later.<BR>A 37-year-old man with HBsAg-and HBeAg-positive chronic hepatitis received steroid withdrawal therapy at the time of elevated transaminase (S-GOT 952u, S-GPT 877u).<BR>The dosage of prednisolone was 40 mg/day at the first week, then decreased by 10 mg everyweek. Total doses were 700 mg in 4 weeks. A rebound S-GOT peak was observed at one week after the discontinuation of prednisolone. At this time, he complained of increasing general fatigue and loss of appetite. The laboratory data showed severe liver dysfunction (Prothrombin time 38%, Hepaplastin test 19%). Ascites was observed by the abdominal CT scanning. Then total bilirubin level increased gradually and urine volume decreased. Finally he died at one month after the discontinuation of prednisolone.