Moon SK, Yoo JJ, Kim SG, Kim YS. Extremely rare case of necrotizing gastritis in a patient with autoimmune hepatitis: A case report. World J Clin Cases 2021; 9(14): 3472-3477 [PMID: 34002160 DOI: 10.12998/wjcc.v9.i14.3472]
Corresponding Author of This Article
Jeong-Ju Yoo, MD, Professor, Department of Gastroenterology and Hepatology, Soonchunhyang University School of Medicine, 170 Jomaru-ro, Wonmi-gu, Bucheon 14584, South Korea. puby17@naver.com
Research Domain of This Article
Gastroenterology & Hepatology
Article-Type of This Article
Case Report
Open-Access Policy of This Article
This article is an open-access article which was selected by an in-house editor and fully peer-reviewed by external reviewers. It is distributed in accordance with the Creative Commons Attribution Non Commercial (CC BY-NC 4.0) license, which permits others to distribute, remix, adapt, build upon this work non-commercially, and license their derivative works on different terms, provided the original work is properly cited and the use is non-commercial. See: http://creativecommons.org/licenses/by-nc/4.0/
World J Clin Cases. May 16, 2021; 9(14): 3472-3477 Published online May 16, 2021. doi: 10.12998/wjcc.v9.i14.3472
Extremely rare case of necrotizing gastritis in a patient with autoimmune hepatitis: A case report
Seung Ki Moon, Jeong-Ju Yoo, Sang Gyune Kim, Young Seok Kim
Seung Ki Moon, Department of Internal Medicine, Soonchunhyang University Bucheon Hospital, Bucheon 14584, South Korea
Jeong-Ju Yoo, Sang Gyune Kim, Young Seok Kim, Department of Gastroenterology and Hepatology, Soonchunhyang University School of Medicine, Bucheon 14584, South Korea
Author contributions: Yoo JJ made the conceptualization, investigation, project administration, written-reviewed and edited; Moon SK made the data curation, resources, formal analysis, visualization, and written-original drafted; Kim SG made methodology; Kim YS made supervision; all authors approved the final manuscript.
Supported byThe Soonchunhyang University Research Fund, No. 20200037.
Informed consent statement: Informed written consent was waived from the Institutional Review Board (IRB) due to the retrospective nature of this case report.
Conflict-of-interest statement: The authors declare that they have no conflict of interest.
CARE Checklist (2016) statement: The authors have read the CARE Checklist (2016). The manuscript was prepared and revised according to the CARE Checklist (2016).
Open-Access: This article is an open-access article that was selected by an in-house editor and fully peer-reviewed by external reviewers. It is distributed in accordance with the Creative Commons Attribution NonCommercial (CC BY-NC 4.0) license, which permits others to distribute, remix, adapt, build upon this work non-commercially, and license their derivative works on different terms, provided the original work is properly cited and the use is non-commercial. See: http://creativecommons.org/Licenses/by-nc/4.0/
Corresponding author: Jeong-Ju Yoo, MD, Professor, Department of Gastroenterology and Hepatology, Soonchunhyang University School of Medicine, 170 Jomaru-ro, Wonmi-gu, Bucheon 14584, South Korea. puby17@naver.com
Received: December 28, 2020 Peer-review started: December 28, 2020 First decision: January 17, 2021 Revised: January 18, 2021 Accepted: March 15, 2021 Article in press: March 15, 2021 Published online: May 16, 2021 Processing time: 122 Days and 1.1 Hours
Abstract
BACKGROUND
Autoimmune hepatitis can cause liver fibrosis, liver cirrhosis, and hepatocellular carcinoma. Its treatment option include the use of steroids and/or immune-suppressive agents such as azathioprine. However, these drugs have some side effects. Thus, close follow-up is needed during treatment. Here, we present an extremely rare case of a patient with an autoimmune hepatitis who died from necrotizing gastritis during immunosuppressive treatment.
CASE SUMMARY
A 52-year-old female patient was diagnosed with autoimmune hepatitis. We treated this patient with immunosuppressive agents. High-dose steroid treatment was initially started. Then azathioprine treatment was added while steroid was tapering. Five weeks after the start of treatment, she visited the emergency room due to generalized abdominal pain and vomiting. After computed tomography scan, the patient was diagnosed with necrotizing gastritis and the patient progressed to septic shock. Treatment for sepsis was continued in the intensive care unit. However, the patient died at 6 h after admission to the emergency room.
CONCLUSION
In patients with autoimmune infections undergoing immunosuppressant therapy, rare complications such as necrotizing gastritis may occur, thus requiring clinical attention.
Core Tip: Primary treatment for autoimmune hepatitis is using immunosuppressants such as steroids and azathioprine. When using immunosuppressants, various side effects may occur. Thus, close observation is necessary. This case report is the first one to describe the occurrence of necrotizing gastritis, a very rare complication of immunosuppressants, in a patient with autoimmune hepatitis.
