Herms Q, Torres S, Kamath PS, Gratacós-Ginès J, Pose E. De novo arthropathy following glucocorticoid treatment for severe alcohol-associated hepatitis: Five case reports. World J Hepatol 2025; 17(12): 110931 [DOI: 10.4254/wjh.v17.i12.110931]
Corresponding Author of This Article
Jordi Gratacós-Ginès, MD, PhD, Liver Unit, Hospital Clínic de Barcelona, Villarroel 170, Barcelona 08036, Catalonia, Spain. jgrata@clinic.cat
Research Domain of This Article
Gastroenterology & Hepatology
Article-Type of This Article
Case Report
Open-Access Policy of This Article
This article is an open-access article which was selected by an in-house editor and fully peer-reviewed by external reviewers. It is distributed in accordance with the Creative Commons Attribution Non Commercial (CC BY-NC 4.0) license, which permits others to distribute, remix, adapt, build upon this work non-commercially, and license their derivative works on different terms, provided the original work is properly cited and the use is non-commercial. See: http://creativecommons.org/licenses/by-nc/4.0/
Dec 27, 2025 (publication date) through Dec 29, 2025
Times Cited of This Article
Times Cited (0)
Journal Information of This Article
Publication Name
World Journal of Hepatology
ISSN
1948-5182
Publisher of This Article
Baishideng Publishing Group Inc, 7041 Koll Center Parkway, Suite 160, Pleasanton, CA 94566, USA
Share the Article
Herms Q, Torres S, Kamath PS, Gratacós-Ginès J, Pose E. De novo arthropathy following glucocorticoid treatment for severe alcohol-associated hepatitis: Five case reports. World J Hepatol 2025; 17(12): 110931 [DOI: 10.4254/wjh.v17.i12.110931]
World J Hepatol. Dec 27, 2025; 17(12): 110931 Published online Dec 27, 2025. doi: 10.4254/wjh.v17.i12.110931
De novo arthropathy following glucocorticoid treatment for severe alcohol-associated hepatitis: Five case reports
Queralt Herms, Sonia Torres, Patrick S Kamath, Jordi Gratacós-Ginès, Elisa Pose
Queralt Herms, Sonia Torres, Jordi Gratacós-Ginès, Elisa Pose, Liver Unit, Hospital Clínic de Barcelona, Barcelona 08036, Catalonia, Spain
Patrick S Kamath, Division of Gastroenterology and Hepatology, Mayo Clinic College of Medicine and Science, Rochester, MN 55905, United States
Jordi Gratacós-Ginès, Elisa Pose, Malalties Hepàtiques i Digestives, Institut d’ Investigacions Biomèdiques August Pi i Sunyer, Barcelona 08036, Catalonia, Spain
Jordi Gratacós-Ginès, Elisa Pose, Enfermedades Hepáticas y Digestivas, Centro de Investigación Biomédica En Red de Enfermedades Hepáticas y Digestivas, Madrid 28029, Spain
Elisa Pose, Faculty of Medicine and Health Sciences, University of Barcelona, Barcelona 08036, Catalonia, Spain
Co-corresponding authors: Jordi Gratacós-Ginès and Elisa Pose.
Author contributions: Herms Q, Torres S, Gratacós-Ginès J, and Pose E contributed to writing original draft; Gratacós-Ginès J and Pose E contributed equally to this manuscript as co-corresponding authors; All authors participated in the manuscript review and editing. All authors have read and approved the final manuscript.
Supported by the Instituto de Salud Carlos III, No. PI22/00910.
Informed consent statement: Informed written consent was obtained from the patient for publication of this report and any accompanying images.
Conflict-of-interest statement: Dr. Gratacós-Ginès reports that Dr. Pose recieved personal fees from GlaxoSmithKline, during the conduct of the study.
CARE Checklist (2016) statement: The authors have read the CARE Checklist (2016), and the manuscript was prepared and revised according to the CARE Checklist (2016).
Open Access: This article is an open-access article that was selected by an in-house editor and fully peer-reviewed by external reviewers. It is distributed in accordance with the Creative Commons Attribution NonCommercial (CC BY-NC 4.0) license, which permits others to distribute, remix, adapt, build upon this work non-commercially, and license their derivative works on different terms, provided the original work is properly cited and the use is non-commercial. See: https://creativecommons.org/Licenses/by-nc/4.0/
Corresponding author: Jordi Gratacós-Ginès, MD, PhD, Liver Unit, Hospital Clínic de Barcelona, Villarroel 170, Barcelona 08036, Catalonia, Spain. jgrata@clinic.cat
Received: June 19, 2025 Revised: July 21, 2025 Accepted: November 17, 2025 Published online: December 27, 2025 Processing time: 190 Days and 20.1 Hours
Abstract
BACKGROUND
Glucocorticoids (GC) are the cornerstone in the treatment of severe alcohol-associated hepatitis (SAH) but may be associated with adverse events.
CASE SUMMARY
We report a prospective series of patients with SAH who were treated with GC and developed de novo arthropathy within 2 weeks of GC cessation. Five patients were included in this series, three of whom were women. All patients underwent ultrasound evaluation and were referred to the Rheumatology Clinics. Final diagnoses were: Arthralgia associated with GC cessation (n = 3), polymyalgia rheumatica (n = 1) and psoriatic arthritis (n = 1). Joint soreness was the main symptom, whereas arthritis occurred rarely. Patients with arthralgia associated with GC cessation required longer regimes of GC and tapering strategies but remained free of symptoms and specific treatment in the long term.
CONCLUSION
De novo arthropathy may occur following GC for SAH. Close monitoring and tapering regimes are advised.
Core Tip: Despite most adverse events following glucocorticoid (GC) administration for severe alcohol-associated hepatitis (SAH) are well-known, joint symptoms are overlooked and not mentioned in hepatology literature. We report a series of five patients, selected from a prospective cohort of patients with biopsy-proven SAH, who developed joint symptoms following GC cessation. Although the final diagnosis varied among patients, the emergence of joint symptoms after GC therapy for SAH represents a novel and noteworthy observation for clinicians managing these cases. In this report we hypothesize that some patients suffered from GC withdrawal syndrome, and we describe the therapeutic approach used.
