Kurokawa M, Hioki T, Aoyagi T, Takahashi M, Imoto K, Goya T, Tanaka M, Kohjima M, Ogawa Y. Clinicopathologic Features of Adult-onset Still's Disease Complicated by Severe Liver Injury.
Intern Med 2024;
63:503-511. [PMID:
37344425 PMCID:
PMC10937138 DOI:
10.2169/internalmedicine.2043-23]
[Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/29/2023] [Accepted: 05/14/2023] [Indexed: 06/23/2023] Open
Abstract
Adult-onset Still's disease (AOSD) is a systemic inflammatory disorder. Severe liver injury has rarely been reported, although liver enzyme elevation is a common complication of AOSD. We herein report four cases of relapsed AOSD with severe liver disorder by tapering or terminating corticosteroids. Liver specimens revealed robust infiltration of inflammatory cells throughout the lobule, especially cluster of differentiation (CD) 8-positive cells. Relapsed AOSD was refractory to corticosteroid reintroduction and required immunosuppressants. Severe liver injury with AOSD is pathologically characterized by extensive lobular infiltration of CD8-positive cells, and we should consider additive immunosuppressive agents on corticosteroids for treatment.
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