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Rescue case of low birth weight infant with acute hepatic failure

World Journal of Gastroenterology 2017年第40期23卷 7337-7342页

作者： Noriki Okada Yukihiro Sanada Taizen Urahashi Yoshiyuki Ihara Naoya Yamada Yuta Hirata Takumi Katano kentaro ushijima Shinya Otomo Shujiro Fujita Koichi Mizuta Department of Transplant Surgery Jichi Medical University Department of Clinical Pharmacology Jichi Medical University Department of Pharmacy Jichi Medical University Department of Pediatrics Yokohama City University School of Medicine

We report a case involving a rescued low birth weight infant(LBWI) with acute liver failure. Case: The patient was 1594 g and 32^(3/7) gestational wk at birth. At the age of 11 d, she developed acute liver failure due to gestational alloimmune liver disease. Exchange transfusion and high-dose gamma globulin therapy were initiated, and body weight increased with enteral nutrition. Exchange transfusion was performed a total of 33 times prior to living donor liver transplantation(LDLT). Her liver dysfunction could not be treated by medications alone. At 55 d old and a body weight of 2946 g, she underwent LDLT using an S2 monosegment graft from her mother. Three years have passed with no reports of intellectual disability or liver dysfunction. LBWIs with acute liver failure may be rescued by LDLT after body weight has increased to over 2500 g.

关键词： Liver transplantation Acute liver failure Low birth weight infant Transplantable body weight Monosegment graft

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Clinical Utility of Procalcitonin for Differentiating between Cryptogenic Organizing Pneumonia and Community-Acquired Pneumonia

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International Journal of Clinical Medicine 2015年第6期6卷 372-376页

作者： Satoshi Takeda Nobuhiko Nagata Hiroyuki Miyazaki Takanori Akagi Taishi Harada Masaru Kodama Shinichiro ushijima Takashi Aoyama kentaro Wakamatsu Masaki Fujita kentaro Watanabe Department of Respiratory Medicine Fukuoka University Chikushi Hospital Chikushino Japan Department of Respiratory Medicine National Hospital Organization Omuta Hospital Omuta Japan Department of Respiratory Medicine Faculty of Medicine Fukuoka University Fukuoka Japan

Background: Differentiating cryptogenic organizing pneumonia (COP) from community-acquired pneumonia (CAP) can be difficult in some cases. Objective: To clarify the clinical utility of procalcitonin (PCT) levels for differentiating between COP and CAP. Methods: Blood PCT levels, leukocyte count, C-reactive protein concentration, number of segments involved on computed tomography (CT) images, and pneumonia severity assessment scale were retrospectively investigated from clinical charts and chest CT images of COP and CAP patients who were admitted to our hospital from 2012 to 2014. The clinical characteristics of COP patients were compared to those of CAP patients for whom causative organisms were not detected. Results: There were 16 COP and 94 CAP patients for whom causative organisms were not detected. Blood PCT levels of all COP patients were less than 0.16 ng/dL, and significantly lower than those of CAP patients (p = 0.0004), while the number of involved segments was significantly higher than that of CAP patients (p = 0.0001). Blood PCT levels and the number of involved segments remained independently significant for differentiating between COP and CAP by multivariate analysis. Receiver operating characteristics curve analysis revealed that 7 was the best cut-off number for involved segments to differentiate between COP and CAP patients with low PCT levels (sensitivity 85.7%, specificity 94.7%). Conclusion: A combination of PCT levels and number of involved segments on CT images is useful for differentiation between COP and CAP.

关键词： Cryptogenic Organizing Pneumonia Procalcitonin Community-Acquired Pneumonia Computed Tomography

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