{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2025,3,19]],"date-time":"2025-03-19T10:09:39Z","timestamp":1742378979206},"reference-count":22,"publisher":"Wiley","issue":"3","license":[{"start":{"date-parts":[[2014,7,18]],"date-time":"2014-07-18T00:00:00Z","timestamp":1405641600000},"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":[[2015,3]]},"abstract":"<jats:p>We present the case of a 25\u2010year\u2010old woman at 16 weeks of gestation who presented with non\u2010comatose autoimmune acute liver failure and was at high risk of developing fulminant hepatitis. Predictive formulas indicated a high probability of developing fulminant hepatitis. Unenhanced computed tomography showed marked hepatic atrophy and broadly heterogeneous hypoattenuating areas. The course of her illness was subacute, and the etiology of liver injury was unclear. Considering all of the above, we predicted a poor prognosis. Plasma exchange (<jats:styled-content style=\"fixed-case\">PE<\/jats:styled-content>) and continuous hemodiafiltration (<jats:styled-content style=\"fixed-case\">CHDF<\/jats:styled-content>) therapy were initiated just after admission. A few days after admission, a high titer (\u00d780) of antinuclear antibody was noted. Because autoimmune hepatitis (<jats:styled-content style=\"fixed-case\">AIH<\/jats:styled-content>) was considered a cause of liver failure, treatment with moderate prednisolone (30\u2009mg\/day) doses was administrated, with careful consideration of her pregnancy. Thereafter, her laboratory findings and clinical course gradually improved without the need for liver transplantation. A liver biopsy at 18 days after admission indicated a diagnosis of <jats:styled-content style=\"fixed-case\">AIH<\/jats:styled-content>. She continued the pregnancy and delivered a healthy baby without any complications. Eventually, prednisolone doses were decreased to 10\u2009mg, after which her liver function worsened. The second liver biopsy also indicated a diagnosis of <jats:styled-content style=\"fixed-case\">AIH<\/jats:styled-content>. Accordingly, low\u2010dose prednisolone and azathioprine doses (50\u2009mg\/day) were administrated to recover her liver function, after which her liver function regained normalcy. This case illustrates that a pregnant woman with non\u2010comatose autoimmune acute liver failure in the first or second trimester of pregnancy and her fetus can be rescued by <jats:styled-content style=\"fixed-case\">PE<\/jats:styled-content>\/<jats:styled-content style=\"fixed-case\">CHDF<\/jats:styled-content> therapy and safe moderate doses of prednisolone.<\/jats:p>","DOI":"10.1111\/hepr.12344","type":"journal-article","created":{"date-parts":[[2014,4,17]],"date-time":"2014-04-17T03:58:54Z","timestamp":1397707134000},"page":"349-355","source":"Crossref","is-referenced-by-count":10,"title":["Pregnant woman with non\u2010comatose autoimmune acute liver failure in the second trimester rescued using medical therapy: A case report"],"prefix":"10.1111","volume":"45","author":[{"given":"Hirokazu","family":"Sato","sequence":"first","affiliation":[{"name":"Division of Gastroenterology and Hepatology Department of Internal Medicine National Defense Medical College  Saitama 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