Giuseppe Marrone1, Francesco Galati2, Marco Biolato2, Cristopher Oddy3, Sara De Carolis4, Angelo Zoli5, Antonio Grieco2. 1. Transplant Hepatology Unit - CEMAD Digestive Disease Center, Fondazione Policlinico Universitario "A. Gemelli" IRCCS, Università Cattolica del Sacro Cuore, Largo A. Gemelli 8, 00168, Rome, Italy. giuseppe.marrone@policlinicogemelli.it. 2. Transplant Hepatology Unit - CEMAD Digestive Disease Center, Fondazione Policlinico Universitario "A. Gemelli" IRCCS, Università Cattolica del Sacro Cuore, Largo A. Gemelli 8, 00168, Rome, Italy. 3. FY2 Intensive Care Medicine, Epsom & St Helier University Hospitals NHS Trust, Epsom, UK. 4. Obstetrics and Obstetric Pathology Unit, Fondazione Policlinico Universitario "A. Gemelli" IRCCS, Università Cattolica del Sacro Cuore, Rome, Italy. 5. Osteo-articular Disease Unit, Fondazione Policlinico Universitario "A. Gemelli" IRCCS, Università Cattolica del Sacro Cuore, Rome, Italy.
Abstract
BACKGROUND: Still's disease is a rare systemic inflammatory disease with frequent but generally mild liver involvement. The most common cause of acute liver failure in western countries is drug-induced liver injury, while it has rarely been reported in subjects suffering from Still's disease. CASE PRESENTATION: We report a case of a young woman presenting with SD reactivation in pregnancy and acute liver failure after delivery with a possible triggering role of drug induced liver injury. CONCLUSIONS: The prompt recognition of Still's disease reactivation allowed early introduction of steroid therapy and resolution of the clinical picture. We discuss potential factors precipitating ALF in this case, and implications for the diagnosis and management of such patients.
BACKGROUND:Still's disease is a rare systemic inflammatory disease with frequent but generally mild liver involvement. The most common cause of acute liver failure in western countries is drug-induced liver injury, while it has rarely been reported in subjects suffering from Still's disease. CASE PRESENTATION: We report a case of a young woman presenting with SD reactivation in pregnancy and acute liver failure after delivery with a possible triggering role of drug induced liver injury. CONCLUSIONS: The prompt recognition of Still's disease reactivation allowed early introduction of steroid therapy and resolution of the clinical picture. We discuss potential factors precipitating ALF in this case, and implications for the diagnosis and management of such patients.
Authors: Naga Chalasani; Robert J Fontana; Herbert L Bonkovsky; Paul B Watkins; Timothy Davern; Jose Serrano; Hongqiu Yang; James Rochon Journal: Gastroenterology Date: 2008-09-17 Impact factor: 22.682