Case Report

Rare Manifestation of a Rare Disease, Acute Liver Failure in Adult Onset Still’s Disease: Dramatic Response to Methylprednisolone Pulse Therapy—A Case Report and Review

Table 1

Characteristics of cases reported on ALF in Adult Onset Still’s Disease (AOSD).

Author [Reference]Gender/Age (Years)Interval between AOSD diagnosis and ALFHepatotoxics prior to the onset of ALFBaseline AOSD treatment before ALFTreatment of ALF associated with AOSD Underwent liver transplantationOutcome

Liese et al.
[3]
F/24Simultaneous NoneNoneExtracorporeal liver supportYesRecovered
Terán et al. [4]M/23AOSD diagnosed after ALF when symptoms recurredNoneNoneSupportive careYesRecovered
Taccone et al.
[5]
F/281 monthNonePrednisolone 8 mg/dayIV Methylprednisolone 500 mg and MARSYesRecovered
Mc Farlane et al.
[6]
M/21<1 monthAcetaminophenAspirin, Acetaminophen,IV one pulse of Methyprednisolone 250 mg and then 20 mg IV BIDYesRecovered
Yamanaka et al.
[7]
F/203 yearsNoneCyclosporine, Prednisolone 15 mg/dayIV Methylprednisolone pulse 500 mg/day for 3 daysYesRecovered
Ogata et al.
[8]
F/203 years NonePrednisolone 15 mg/day2 days of pulse IV Methyl prednisolone 1 gm per day and then plasma exchangeYesRecovered
Dino et al.
[9]
F/44Simultaneous Aspirin 1.8 gram/dayNoneIV MethylPrednisolone 1 gm/day for 2 daysYesDied
Thabah et al.
[13]
F/2910 daysIndomethacinPO Prednisolone 40 mg/day and indomethacinSteroidsNoDied
Ott et al.
[14]
F/25Simultaneous NonePrednisolone 16 mg/day for an undetermined rheumatic disease UDCANoRecovered
Linde et al.
[15]
F/39SimultaneousAcetaminophen, IbuprofenNSAIDs3 days of IV Methyprednisolone 250 mg per dayNoRecovered
Mylona et al.
[16]
M/462 monthsNoneTapering dose of PrednisolonePrednisolone 75 mg/day PO and Anakinra 100 mg/day PONoRecovered
Nagashima et al.
[17]
F/513 yearsIndomethacinOral betamethasone, methotrexate and IndomethacinIV Pulse dexamethasone 100 mg/day and Cyclosporine 120 mg/dayNoRecovered
F/322 weeksNonePrednisolone 50 mg/day and Cyclosporine 150 mg/day3 days of IV dexamethasone pulse therapy 120 mg/day, dexamethasone 5 mg/day cyclosporineNoRecovered
Hogan et al.
[18]
F/35SimultaneousNoneSulfasalazine for rheumatic disease2 days of Methylprednisolone 80 mg IV every 8 hrsNoRecovered
Takami et al.
[19]
F/74SimultaneousNoneNonePrednisolone 30 mg/dayNoRecovered
Schuster et al.
[20]
50 ySimultaneousNoneNonePrednisolone, methotrexateNoRecovered
Atsukawa et al.
[21]
34NMNoneNonePrednisolone 40 mg/dayNoRecovered

Gm/dL-grams/deciliter, IV-Intravenous, PO-peroral, MARS-Molecular Adsorbent Recirculating System, mg-milligrams, BID-twice a day, UDCA-Ursodeoxycholic acid, NSAIDS-Non steroidal anti inflammatory drugs, hrs-hours, NM-Not mentioned.