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ID 119167
タイトル別表記
A Case Of Hepatic Sinusoidal Obstruction Syndrome During The Treatment Of Rheumatoid Arthritis
肝類洞閉塞症候群
著者
矢野, 花佳 徳島大学
堀, 明日香 徳島大学
三橋, 威志 徳島大学
樫原, 孝典 徳島大学
キーワード
hepatic sinusoidal obstruction syndrome
rheumatoid arthritis
trans jugular liver biopsy
methotrexate
iguratimod
資料タイプ
学術雑誌論文
抄録
A female patient in her 60s who was diagnosed with rheumatoid arthritis has been treated with methotrexate for 12 years, and iguratimod for 7 years. She was referred to our department because of the liver injury and ascites. In laboratory data, PT-INR was 1.26( 63.2%), serum albumin was 1.9g/dL, M2BPGi was 4.97COI, indicating liver fibrosis and decreased hepatic synthesis ability. An abdominal ultrasonography(AUS) showed ascites, and liver stiffness value was 12.7 kPa using shear wave elastography, indicating F4 fibrosis in new Inuyama classification. Histopathological examination of liver biopsy showed A2 chronic active hepatitis and F2 - 3 fibrosis. In Azan staining, it showed luminal stenosis of central vein. Therefore, she was diagnosed with hepatic sinusoidal obstruction syndrome. We discontinued the administration of methotrexate and iguratimod, and then liver function was gradually improved. Hepatic sinusoidal obstruction syndrome is often associated with hematopoietic stem cell transplantation, chemotherapy drugs such as oxaliplatin, and radiation therapy. In our knowledge, this is the first report of the case with hepatic sinusoidal obstruction syndrome, which occurred during the course of rheumatoid arthritis treatment.
掲載誌名
四国医学雑誌
ISSN
00373699
27583279
出版者
徳島医学会
79
5-6
開始ページ
263
終了ページ
268
並び順
263
発行日
2024-03-11
出版社版DOI
出版社版URL
フルテキストファイル
言語
jpn
著者版フラグ
出版社版
部局
医学系
病院