{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,4,21]],"date-time":"2026-04-21T11:58:54Z","timestamp":1776772734903,"version":"3.51.2"},"reference-count":31,"publisher":"Wiley","issue":"5","license":[{"start":{"date-parts":[[2013,5,22]],"date-time":"2013-05-22T00:00:00Z","timestamp":1369180800000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/onlinelibrary.wiley.com\/termsAndConditions#vor"}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["Hepatology Research"],"published-print":{"date-parts":[[2014,5]]},"abstract":"<jats:sec><jats:title>Aim<\/jats:title><jats:p>Acute liver failure (<jats:styled-content style=\"fixed-case\">ALF<\/jats:styled-content>) is a worldwide problem despite its rare incidence because of its extremely high mortality. There are no beneficial therapies except for emergency liver transplantation for <jats:styled-content style=\"fixed-case\">ALF<\/jats:styled-content>. However, in <jats:styled-content style=\"fixed-case\">J<\/jats:styled-content>apan where the problem of a shortage of donor livers still remains, therapies other than transplantation must be further investigated for patients with <jats:styled-content style=\"fixed-case\">ALF<\/jats:styled-content>. Our aim was to elucidate the efficacy of high\u2010dose corticosteroid (<jats:styled-content style=\"fixed-case\">CS<\/jats:styled-content>) in decreasing liver enzyme levels in the early stage of <jats:styled-content style=\"fixed-case\">ALF<\/jats:styled-content>.<\/jats:p><\/jats:sec><jats:sec><jats:title>Methods<\/jats:title><jats:p>Thirty\u2010one consecutive <jats:styled-content style=\"fixed-case\">J<\/jats:styled-content>apanese patients with viral <jats:styled-content style=\"fixed-case\">ALF<\/jats:styled-content> in the early stage were prospectively examined for their clinical and biochemical features and treatment responses during 2 weeks after the start of treatment. Nineteen were treated with high\u2010dose methylprednisolone, and 12 having clinical and biochemical backgrounds with no significant difference were treated without <jats:styled-content style=\"fixed-case\">CS<\/jats:styled-content>.<\/jats:p><\/jats:sec><jats:sec><jats:title>Results<\/jats:title><jats:p>The aspartate aminotransferase\u2009:\u2009alanine aminotransferase ratio became lower in patients treated with <jats:styled-content style=\"fixed-case\">CS<\/jats:styled-content> than in controls (<jats:italic>P<\/jats:italic>\u2009&lt;\u20090.05). Fifteen of 19 patients in the <jats:styled-content style=\"fixed-case\">CS<\/jats:styled-content> group and eight of 12 in the control group recovered (<jats:italic>P<\/jats:italic>\u2009=\u20090.36). Hepatitis <jats:styled-content style=\"fixed-case\">B<\/jats:styled-content> viral infection and advanced liver damage at the start of treatment were associated with poor prognosis (<jats:italic>P<\/jats:italic>\u2009&lt;\u20090.05). Complications during the therapy were not greater in the <jats:styled-content style=\"fixed-case\">CS<\/jats:styled-content> group than control (<jats:italic>P<\/jats:italic>\u2009=\u20090.64).<\/jats:p><\/jats:sec><jats:sec><jats:title>Conclusion<\/jats:title><jats:p>The introduction of high\u2010dose <jats:styled-content style=\"fixed-case\">CS<\/jats:styled-content> in the early stage of <jats:styled-content style=\"fixed-case\">ALF<\/jats:styled-content> was effective in suppressing the destruction of hepatocytes. <jats:styled-content style=\"fixed-case\">CS<\/jats:styled-content>\u2010treated patients showed slightly higher survival rates and slightly more improved liver regeneration than controls, although the differences were not statistically significant.<\/jats:p><\/jats:sec>","DOI":"10.1111\/hepr.12148","type":"journal-article","created":{"date-parts":[[2013,4,26]],"date-time":"2013-04-26T11:03:19Z","timestamp":1366974199000},"page":"491-501","source":"Crossref","is-referenced-by-count":46,"title":["Efficacy of high\u2010dose corticosteroid in the early stage of viral acute liver failure"],"prefix":"10.1111","volume":"44","author":[{"given":"Keiichi","family":"Fujiwara","sequence":"first","affiliation":[{"name":"Department of Gastroenterology and Nephrology Chiba University  Chiba Japan"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Shin","family":"Yasui","sequence":"additional","affiliation":[{"name":"Department of Gastroenterology and Nephrology Chiba University  Chiba Japan"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Yutaka","family":"Yonemitsu","sequence":"additional","affiliation":[{"name":"Department of Gastroenterology and Nephrology Chiba University  Chiba Japan"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Rintaro","family":"Mikata","sequence":"additional","affiliation":[{"name":"Department of Gastroenterology and Nephrology Chiba University  Chiba Japan"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Makoto","family":"Arai","sequence":"additional","affiliation":[{"name":"Department of Gastroenterology and Nephrology Chiba University  Chiba Japan"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Tatsuo","family":"Kanda","sequence":"additional","affiliation":[{"name":"Department of Gastroenterology and Nephrology Chiba University  Chiba Japan"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Fumio","family":"Imazeki","sequence":"additional","affiliation":[{"name":"Department of Gastroenterology and Nephrology Chiba University  Chiba Japan"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Shigeto","family":"Oda","sequence":"additional","affiliation":[{"name":"Department of Emergency and Critical Care Medicine Graduate School of Medicine Chiba University  Chiba Japan"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Osamu","family":"Yokosuka","sequence":"additional","affiliation":[{"name":"Department of Gastroenterology and Nephrology Chiba University  Chiba Japan"}],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"311","published-online":{"date-parts":[[2013,5,22]]},"reference":[{"key":"e_1_2_6_2_1","doi-asserted-by":"publisher","DOI":"10.1111\/j.1872-034X.2011.00860.x"},{"key":"e_1_2_6_3_1","doi-asserted-by":"publisher","DOI":"10.1111\/j.1872-034X.2010.00755.x"},{"key":"e_1_2_6_4_1","doi-asserted-by":"publisher","DOI":"10.1007\/s00535-012-0624-x"},{"key":"e_1_2_6_5_1","doi-asserted-by":"crossref","first-page":"357","DOI":"10.1016\/S0016-5085(52)80035-6","article-title":"Cortisone, ACTH and antibiotics in fulminant hepatitis","volume":"21","author":"Ducci H","year":"1952","journal-title":"Gastroenterology"},{"key":"e_1_2_6_6_1","doi-asserted-by":"publisher","DOI":"10.7326\/0003-4819-38-6-1148"},{"key":"e_1_2_6_7_1","doi-asserted-by":"publisher","DOI":"10.1016\/S0016-5085(62)80023-7"},{"key":"e_1_2_6_8_1","first-page":"130","article-title":"A controlled trial of steroid therapy in massive hepatic necrosis","volume":"62","author":"Ware AJ","year":"1974","journal-title":"Am J Gastroenterol"},{"key":"e_1_2_6_9_1","doi-asserted-by":"publisher","DOI":"10.1097\/00005792-196903000-00003"},{"key":"e_1_2_6_10_1","doi-asserted-by":"publisher","DOI":"10.1056\/NEJM197603252941315"},{"key":"e_1_2_6_11_1","doi-asserted-by":"publisher","DOI":"10.1056\/NEJM197603252941301"},{"key":"e_1_2_6_12_1","doi-asserted-by":"publisher","DOI":"10.1136\/gut.20.7.620"},{"key":"e_1_2_6_13_1","doi-asserted-by":"publisher","DOI":"10.1007\/BF01307513"},{"key":"e_1_2_6_14_1","doi-asserted-by":"publisher","DOI":"10.1111\/j.1872-034X.2008.00322.x"},{"key":"e_1_2_6_15_1","doi-asserted-by":"publisher","DOI":"10.1111\/j.1872-034X.2012.01105.x"},{"key":"e_1_2_6_16_1","unstructured":"TsubouchiH OketaniM.Fulminant hepatitis and late onset hepatic failure (LOHF) in Japan (2004). 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