Case Report
Copyright ©The Author(s) 2015. Published by Baishideng Publishing Group Inc. All rights reserved.
World J Gastroenterol. Jul 14, 2015; 21(26): 8203-8207
Published online Jul 14, 2015. doi: 10.3748/wjg.v21.i26.8203
Anti-inflammatory effect of recombinant thrombomodulin for fulminant hepatic failure
Kazutaka Kurokohchi, Osamu Imataki, Fumiyoshi Kubo
Kazutaka Kurokohchi, Osamu Imataki, Fumiyoshi Kubo, Department of Internal Medicine, Uchinomi Hospital, Kagawa 761-0793, Japan
Osamu Imataki, Division of Hematology, Department of Internal Medicine, Faculty of Medicine, Kagawa University, Kagawa 761-0793, Japan
Author contributions: Kurokohchi K managed the patient’s case, contributed to the literature search, and wrote the manuscript; Kurokohchi K made substantial contributions to the concept and design of the report; Imataki O qualified the patient’s data, suggested important intellectual content, and reviewed the manuscript; Kurokohchi K and Imataki O contributed equally to this work; Kubo F was involved in the drafting and supervision of the manuscript and took part in critical discussions; all authors read and approved the final version of the manuscript.
Informed consent statement: All study participants, or their legal guardian, provided written informed consent prior to study enrollment.
Conflict-of-interest statement: The authors declare that they have no competing interests.
Open-Access: 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/
Correspondence to: Dr. Osamu Imataki, Division of Hematology and Stem Cell Transplantation, Department of Internal Medicine, Faculty of Medicine, Kagawa University, 1750-1 Ikenobe, Miki-cho, Kita-gun, Kagawa 761-0793, Japan. oima@med.kagawa-u.ac.jp
Telephone: +81-878-912145 Fax: +81-878-912147
Received: November 16, 2014
Peer-review started: November 17, 2014
First decision: December 29, 2014
Revised: March 1, 2015
Accepted: March 18, 2015
Article in press: March 19, 2015
Published online: July 14, 2015
Core Tip

Core tip: Fulminant hepatic failure (FHF) is a critical illness that can be comorbid to primary liver damage. However, no standard therapy for the treatment of FHF has been established. We experienced a fatal FHF case with systemic inflammatory response syndrome followed by disseminated intravascular coagulopathy (DIC). We administered recombinant thrombomodulin (rTM) for the treatment of DIC, which ameliorated all lethal conditions (coagulopathy and inflammation). Monitoring of proinflammatory cytokines, hepatocyte growth factor, and prothrombin time revealed the response of FHF to rTM. We hypothesized an anti-inflammatory effect of rTM-enhanced hepatocyte regeneration through inactivation of high-mobility group box 1.