악성 림프종 환자에서 고용량 스테로이드 요법에 의한 급성 간부전

Abstract

Glucocorticoid (GC) is widely used as an anti-emetic drug, an anti-inflammatory drug, or a pain killer for cancer patients. Though only a few cases of GC-induced hepatopathy were reported, the clinical course were mild and reversible, and the GC has also been used for the treatment of autoimmune hepatitis. Here, we found a case of fatal hepatic failure in a 52-year-old man with relapsed diffuse large B-cell lymphoma following high-dose glucocorticoid. Computed tomography (CT) scan revealed shrinkage of liver volume and large amount of ascites, indicating the aggravation of liver cirrhosis. The laboratory finding was consistent with hepatic failure: high bilirubin and prolonged prothrombin time. The patient died of hepatic failure and sepsis. Here, we discussed the mechanism of glucocorticoid-induced hepatopathy and proposed a new hypothesis on the glucocorticoid-induced hepatic failure in the patient with underlying liver disease.