Fulminant presentation of XXXX : clinical features and early predictors of corticosteroid treatment failure.

@entity1 @entity1087 @entity19180 @entity75 @entity879 @entity228 @entity177 @entity3851 @entity775
BACKGROUND AND AIMS: Classical features of @entity775 ( @entity19180 ) may be altered during the abrupt onset of the disease. @entity228 therapy can be life-saving, but its use in the fulminant presentation of @entity19180 ( @entity19180 ) remains controversial. We aimed to assess the clinical features of @entity1 with @entity19180 and to describe the role of corticosteroids in this population. @entity1 AND METHODS: We retrospectively analyzed 154 adult @entity1 with @entity879 who were admitted to six liver transplantation (LT) programs. The @entity19180 simplified criteria were used to identify @entity1 with @entity19180 . RESULTS: We identified 40 (26%) @entity1 with @entity19180 . Compared with other etiologies, @entity1 with @entity19180 presented a longer interval from @entity1087 to @entity75 (26 vs. 16 days, P=0.02) and a lower @entity3851 ( @entity3851 ) score on admission (29 vs. 33, P=0.002). Overall, 25 (62%) @entity1 with @entity19180 underwent LT, eight (20%) @entity1 survived, and seven (18%) died without LT. Seventeen @entity1 received corticosteroids therapy, of whom seven (41%) survived without LT. Among the treated @entity1 , higher @entity3851 score and @entity75 grade of 3 or more were associated significantly with @entity177 . CONCLUSION: @entity1 with @entity19180 have a more indolent presentation compared with the non- @entity19180 population. Altogether, only eight (20%) @entity1 presenting with @entity19180 survived without LT. A subset of @entity1 with @entity19180 and an initial @entity3851 score less than 27 and low-grade hepatic @entity75 might benefit from administration of corticosteroids.
