Hemoadsorption with CytoSorb in a Patient of Sepsis, AKI and Acute Fulminant Hepatitis: A Case Report from Bangladesh

Abstract

Sepsis, a life-threatening condition characterized by dysregulated immune responses and multi-organ dysfunction, remains a significant therapeutic challenge. This case report highlights the successful use of hemoadsorption therapy (CytoSorb) in a 35-year-old female with sepsis, acute fulminant hepatitis, and multi-organ failure. The patient initially presented with fever, jaundice, and oliguria, progressing to respiratory distress and worsening renal and hepatic function. Despite initial antibiotic therapy and haemodialysis, her condition deteriorated, prompting the initiation of CytoSorb hemoadsorption integrated with renal replacement therapy (RRT). Two 12-hour hemoadsorption sessions over 48 hours led to marked clinical and biochemical improvement, including a reduction in serum bilirubin from 24.1 mg/dl to 5.6 mg/dl, Alanine Aminotransfarese (ALT) from 335 U/L to 59 U/L, and procalcitonin from 23.2 μg/L to 9.54 μg/L. The patient’s respiratory distress resolved, and she achieved haemodynamic stability, allowing transfer to the general ward and subsequent discharge without complications. This case underscores the potential of hemoadsorption therapy in modulating the inflammatory response and supporting organ recovery in complex sepsis cases. CytoSorb’s efficacy in reducing cytokine load and improving hepatic and renal function highlights its role as a valuable adjunct in sepsis management. Further studies are warranted to establish long-term outcomes and cost-effectiveness compared to other extracorporeal therapies.