Internal Medicine
Online ISSN : 1349-7235
Print ISSN : 0918-2918
ISSN-L : 0918-2918
Repeated Jaundice due to YMDD Mutant in a Patient with Prolonged Lamivudine Therapy for Chronic Hepatitis B under Prednisolone Treatment for Still's Disease
Riho JOHKiyoshi HASEGAWANobuyuki TORIIMiho OGAWANaoko KANAITakuma NARITOMIKayo ISHIKAWAAiko IIZUKAToru SHIZUMAEtsuko HASHIMOTONaoaki HAYASHI
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Keywords: breakthrough, steroid
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2002 Volume 41 Issue 9 Pages 701-705

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Abstract

A 50-year-old woman patient began receiving lamivudine because of acute exacerbation of chronic hepatitis B. She also suffered from adult-onset Still's disease and had received prednisolone for 5 years. Lamivudine was effective for treatment of the first flare. Fifteen months after lamivudine treatment was started, a breakthrough due to lamivudine-resistant strain M552I occurred. Between 10 and 12 months after the breakthrough, flare with jaundice occurred 3 times. We decided interferon would not be suitable, because it could induce activation of Still's disease. Prolonged lamivudine therapy is only recommended in cases of hepatitis B in which there is no alternative treatment.
(Internal Medicine 41: 701-705, 2002)

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