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Reversibility of type 1 hepatorenal syndrome in patientwith acute alcoholic hepatitis complicated with acute pancreatitis after continual terlipressininfusion and albumin plasmaexpansion - Case report


Reverzibilita hepatorenálnehosyndrómu 1. typu u pacientas akútnou alkoholovouhepatitídou komplikovanouakútnou pankreatitídou pokontinuálnej infúzii terlipressinua plazmaexpanzii albumínom

36-ročný muž bol prijatý na I. internú kliniku FNsP a LF UPJŠ v Košiciach pre akútnualkoholovú hepatitídu s extrémne elevovanými hepatálnymi testami (ALT: 113,1 kat/l, AST:416,1 kat/l) komplikovanú akútnou pankreatitídou a obojstrannou bronchopneumoniou. Diagnostikovalisme hepatorenálny syndróm 1. typu. Pacient bol liečený kontinuálnou infúziouterlipressinu v dávke 1 mg denne v kombinácii s plazmaexpanziou albumínom (20 g denne),liečba trvala 15 dní. Terapia viedla k normalizácii sérového kreatinínu, sodíka a obličkovýchfunkcií, k zvýšeniu diurézy a natriurézy. Vyliečili sme akútnu pankreatitídu a bronchopneumoniu.Normalizované obličkové funkcie a upravené pečeňové funkcie pretrvávali aj po skončeníliečby.

Klíčová slova:
akútna alkoholová hepatitída - akútna pankreatitída - hepatorenálny syndróm- terlipressin - albumín.


Authors: P. Jarčuška;  E. Veseliny;  M. Zakuciová
Authors‘ workplace: I. interná klinika FNsP a LF UPJŠ, Košice, Slovakia, prednosta doc. MUDr. T. Hildebrand, CSc.
Published in: Prakt. Lék. 2004; (9): 519-522
Category:

Overview

A 36-year-old man was admitted at 1st Department of Internal Medicine, University Hospitalin Košice because of acute alcoholic hepatitis with extremely elevated aminotransferases (ALT:113,1 kat/l, AST: 416,1 kat/l) complicated with acute pancreatitis and bilateral bronchopneumonia.Hepatorenal syndrome type 1 was diagnosed. Patient was treated by continualterlipressin infusion /1 mg daily) in combination with albumin (20 g daily) plasma expansionfor 15 days. The therapy led to serum creatinine, serum sodium and kidney function normalisation.Diuresis and natriuresis increase was induced by the therapy. Acute pancreatitis andbronchopneumonia were recovered. Normalised kidney functions and improved liver functionshad persisted after termination of therapy.

Key words:
acute alcoholic hepatitis - acute pancreatitis - hepatorenal syndrome - terlipressin- albumin.

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Labels
General practitioner for children and adolescents General practitioner for adults

Article was published in

General Practitioner


2004 Issue 9
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