Published online May 16, 2021. doi: 10.12998/wjcc.v9.i14.3472
Peer-review started: December 28, 2020
First decision: January 17, 2021
Revised: January 18, 2021
Accepted: March 15, 2021
Article in press: March 15, 2021
Published online: May 16, 2021
Autoimmune hepatitis can cause liver fibrosis, liver cirrhosis, and hepatocellular carcinoma. Its treatment option include the use of steroids and/or immune-suppressive agents such as azathioprine. However, these drugs have some side effects. Thus, close follow-up is needed during treatment. Here, we present an extremely rare case of a patient with an autoimmune hepatitis who died from necrotizing gastritis during immunosuppressive treatment.
A 52-year-old female patient was diagnosed with autoimmune hepatitis. We treated this patient with immunosuppressive agents. High-dose steroid treatment was initially started. Then azathioprine treatment was added while steroid was tapering. Five weeks after the start of treatment, she visited the emergency room due to generalized abdominal pain and vomiting. After computed tomography scan, the patient was diagnosed with necrotizing gastritis and the patient progressed to septic shock. Treatment for sepsis was continued in the intensive care unit. However, the patient died at 6 h after admission to the emergency room.
In patients with autoimmune infections undergoing immunosuppressant therapy, rare complications such as necrotizing gastritis may occur, thus requiring clinical attention.
Core Tip: Primary treatment for autoimmune hepatitis is using immunosuppressants such as steroids and azathioprine. When using immunosuppressants, various side effects may occur. Thus, close observation is necessary. This case report is the first one to describe the occurrence of necrotizing gastritis, a very rare complication of immunosuppressants, in a patient with autoimmune hepatitis.