Successful treatment of drug‐induced acute liver failure with high‐volume plasma exchange |
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Authors: | Chung‐Te Liu Tso‐Hsiao Chen Chung‐Yi Cheng |
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Institution: | Division of Nephrology, Department of Internal Medicine, Wan Fang Hospital, Taipei Medical University, , Taipei, Taiwan |
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Abstract: | We report two patients with drug‐induced liver injury (DILI)‐related acute liver failure (ALF) who were successfully treated with high‐volume plasma exchange without liver transplantation. The first patient was a 66‐year‐old man admitted because of a perforated duodenal ulcer complicated with peritonitis and septic shock. After treatment with multiple antibiotics, the patient developed DILI and ALF. Grade 3 hepatic encephalopathy and profound jaundice were present. Symptoms and signs of ALF improved dramatically after initiation of plasma exchange. The patient was discharged uneventfully. The second patient was a 94‐year‐old man admitted for treatment of newly diagnosed pulmonary tuberculosis. DILI and ALF developed 5 days after initiation of anti‐tuberculosis treatment. Grade 4 hepatic encephalopathy was present. After plasma exchange, the patient's level of consciousness improved dramatically, and he recovered from ALF. These 2 cases show the potential of plasma exchange in the treatment of DILI despite occurrence acute liver failure. J. Clin. Apheresis, 28:430–434, 2013. © 2013 Wiley Periodicals, Inc. |
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Keywords: | plasma exchange artificial liver support acute liver failure drug‐induced liver injury |
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