Severe progression of autoimmune hepatitis in a young COVID-19 adult patient: A case report
Journal of Acute Disease
; 11(4):161-164, 2022.
Article
in English
| EMBASE | ID: covidwho-2066827
ABSTRACT
Rationale The impact of COVID-19 in patients with autoimmune liver disease treated with immunosuppressive therapy has not been described so far. This case report describes the clinical course of a patient with autoimmune hepatitis (AIH) who developed COVID-19 and the features of cytokine syndrome leading to its deterioration in our intensive care unit. Patient's Concern A 28-year-old male presented with generalized anasarca for two weeks and chronic liver disease for 8 months. Diagnosis AIH and Covid-19 with features of cytokine storm syndrome. Interventions:
Intravenous furosemide, mannitol, syrup lactulose, steroids (prednisolone 40 mg), azathioprine 1 mg/kg body weight, rifaximin, vitamin K, and blood products.Outcomes:
The patient had hepatic encephalopathy and AIH and died on the 10th day after admission despite ventilatory support, sustained low-efficiency hemodialysis, and resuscition. Lessons The dramatic release of cytokines and the inflammatory-immune responses not only alter the pathophysiology but also affects the onset and severity of disease progression in patients with AIH.
ammonia; antinuclear antibody; azathioprine; carvedilol; creatinine; doxycycline; fresh frozen plasma; furosemide; glucose; hepatitis B surface antigen; immunoglobulin G; infusion fluid; lactulose; mannitol; metronidazole; neutrophil cytoplasmic antibody; oxygen; piperacillin plus tazobactam; prednisolone; rifaximin; smooth muscle antibody; sodium chloride; urea; vitamin K group; abdomen; adult; alcohol consumption; anasarca; antibody titer; article; artificial ventilation; ascites; autoimmune hepatitis; blood analysis; body weight; breathing rate; case report; chronic liver disease; clinical article; clinical feature; coronavirus disease 2019; cryoprecipitate; cytokine release syndrome; diastolic blood pressure; disease course; disease exacerbation; disease severity; disorientation; echography; face edema; foot edema; gallbladder wall; general condition deterioration; Glasgow coma scale; glucose blood level; heart rate; hematocrit; hemodialysis; hepatic encephalopathy; Hepatitis C virus; hepatitis virus; hospital admission; human; Human immunodeficiency virus; hypertension; image analysis; intensive care unit; liver hilus; lower limb; male; pallor; platelet count; positive end expiratory pressure ventilation; respiratory distress; resuscitation; sclera; skin discoloration; splenomegaly; syrup; systolic blood pressure; unconsciousness; urinalysis; urine volume
Full text:
Available
Collection:
Databases of international organizations
Database:
EMBASE
Type of study:
Case report
Language:
English
Journal:
Journal of Acute Disease
Year:
2022
Document Type:
Article
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