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© 1993 British Society for Rheumatology

case-report

REMISSION OF SEVERE RHEUMATOID ARTHRITIS FOLLOWING LIVER TRANSPLANTATION

A W. LOHSE*, G. OTTO{dagger}, T. PORALLA* and K. H. MEYER ZUM BÜSCHENFELDE*

*1. Department of Medicine, Johannes Gutenberg University Langenbeckstr. 1, D-6500 Mainz
{dagger}Department of Surgery, Ruprechi-Karls-University Im Neuenheimer Feld 110, D-6900 Heidelberg, Germany

We present the case of a 32-year-old male who suffered from severe RA from the age of 21 years. After 9 years of active disease and poor response to therapy the patient developed severe hepatitis induced by the NSAID pirprofen. He went into fulminant hepatic failure necessitating emergency liver transplantation. Liver transplantation was followed by clinical and laboratory remission of his RA and he has remained virtually asymptomatic for more than 3.5 years. The possibility that this favourable clinical course was due to the immunosuppressive effect of the liver transplant rather than the ensuing immunosuppressive therapy is discussed.

KEY WORDS: Rheumatoid arthritis, Liver transplantation, Immunosuppression, Cyclosporin, Corticosteroids


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