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Nonalcoholic Steatohepatitis—A Long-Term Follow-Up Study: Comparison with Alcoholic Hepatitis in Ambulatory and Hospitalized Patients

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Abstract

A previous publication analyzed the clinicopathological characteristics of 105 patients with steatohepatitis: 32 nonalcoholic, 21 ambulatory alcoholics, and 52 hospitalized alcoholics; we now report an up to 12-year follow-up (mean 5.9 ± 4.7). Between 1988 and 1993, all patients with a histological diagnosis of steatohepatitis were included; necrosis, inflammation, Mallory bodies, and fibrosis were graded. Complete follow-up data were obtained in 78%. Survival curves were similar between nonalcoholic and ambulatory alcoholics; they were, however, better in nonalcoholic than hospitalized alcoholics (P < 0.0001), and in ambulatory relative to hospitalized (P = 0.0001) alcoholics. Nonalcoholics had a better prognosis than the combined alcoholic groups (P = 0.001). Patients with moderate to severe Mallory bodies and severe fibrosis had a significantly worse survival (P < 0.01), whereas severity of hepatocellular damage and neutrophil or mononuclear infiltration had no significant impact. In conclusion, alcoholic patients as a whole had a worse prognosis, yet the ambulatory subgroup had a prognosis similar to nonalcoholic patients.

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References

  1. Teli M, James OF, Burt AD, Bennett MK, Day CP: The natural history of nonalcoholic fatty liver: A follow-up study. Hepatology 22:1714-1719, 1995

    Google Scholar 

  2. Matteoni CA, Younossi ZM, Gramlich T, Boparai N, Liu YC, McCullough AJ: Nonalcoholic fatty liver disease: a spectrum of clinical and pathological severity. Gastroenterology 116:1413-1419, 1999

    Google Scholar 

  3. Powell EE, Cooksley WG, Hanson R, Searle J, Halliday RW, Powell LW: The natural history of nonalcoholic steatohepatitis: A follow-up study of 42 patients follow for up to 21 years. Hepatology 11:74-80, 1990

    Google Scholar 

  4. Lee RG: Nonalcoholic steatohepatitis. A study of 49 patients. Hum Pathol 20:594-598, 1989

    Google Scholar 

  5. Bacon BR, Farahvash MJ, Janney CG, Neuschwander-Tetri BA: Nonalcoholic steatohepatitis: an expanded clinical entity. Gastroenterology 107:1103-1109, 1994

    Google Scholar 

  6. Pinto HC, Abrantes A, Esteves AV, Almeida H, Correia JP: Long-term prognosis of patients with cirrhosis of the liver and upper gastrointestinal bleeding. Am J Gastroenterol 84:1239-1243, 1989

    Google Scholar 

  7. McCormick PA, Morgan MY, Phillips A, Yin TP, McIntyre N, Burroughs AK: The effects of alcohol use on rebleeding and mortality in patients with alcoholic cirrhosis following variceal haemorrhage. J Hepatol 14:99-103, 1992

    Google Scholar 

  8. D'Amico G, Morabito A, Pagliaro L, Marubini E: Survival and prognostic indicators in compensated and decompensated cirrhosis. Dig Dis Sci 31:468-475, 1986

    Google Scholar 

  9. Chedid A, Mendenhall CL, Garside P, French SW, Chen T, Rabin L: Prognostic factors in alcoholic liver disease. Am J Gastroenterol 86:210-216, 1991

    Google Scholar 

  10. Cortez-Pinto H, Baptista A, Camilo E, Valente A, Saragoça A, Moura MC: Nonalcoholic steatohepatitis clinicopathological comparison with alcoholic hepatitis in ambulatory and hospitalized patients. Dig Dis Sci 41:172-179, 1996

    Google Scholar 

  11. Leevy CM, Tamburro CH, Zetterman R: Liver disease of the alcoholic. Med Clin North Am 59:909-918, 1975

    Google Scholar 

  12. Mendenhall CL: Alcoholic hepatitis. In Diseases of the Liver. L Schiff, ER Schiff, (eds). Philadelphia, 1993

  13. Galambos JT: Alcoholic hepatitis. In Clinical Hepatology: History, Present State, Outlook. G Csomós, H Thaler, (eds). New York, Springer-Verlag, 1983, pp: 321-335

    Google Scholar 

  14. Beckett AG, Livingstone AV, Hill KR: Acute alcoholic hepatitis. Br Med J 1:1113-1119, 1961

    Google Scholar 

  15. Ludwig J, Viggiano RT, McGill DB, Ott BJ: Nonalcoholic steatohepatitis. Mayo Clinic experiences with a hitherto unnamed disease. Mayo Clin Proc 55:434-438, 1980

    Google Scholar 

  16. Pares A, Caballeria J, Brugera M, Torres M, Rodes J: Histologic course of alcoholic hepatitis: influence of abstinence, sex, and extent of hepatic damage. J Hepatol 2:33-42, 1986

    Google Scholar 

  17. Teli MR, Day CP, Burt AD, Bennett MK, James OFW: Determinants of progression to cirrhosis or fibrosis in pure alcoholic fatty liver. Lancet 346:987-990, 1995

    Google Scholar 

  18. Nordmann R, Ribière C, Rouach H: Implication of free Radical mechanisms in ethanol-induced cellular injury. Free Radic Biol Med 12:219-240, 1992

    Google Scholar 

  19. Niemelä O, Parkkila S, Ylä-Herttuala S, Villanueva J, Ruebner B, Halsted CH: Sequential acetaldehyde production, lipid peroxidation, and fibrogenesis in micropig model of alcohol-induced liver disease. Hepatology 22:1208-1214, 1995

    Google Scholar 

  20. Lettéron P, Fromenty B, Terris B, Degott C, Pessayre D: Acute and chronic hepatic steatosis lead to in vivo lipid peroxidation in mice. J Hepatol 24:200-208, 1996

    Google Scholar 

  21. Cortez-Pinto H, Filipe P, Camilo ME, Baptista A, Fernandes A, Moura MC: A peroxidação dos lípidos na esteatohepatite não alcoólica: relação com a esteatose. GE—Jo Port Gastrenterol 6:234-240, 1999

    Google Scholar 

  22. Cortez-Pinto H: Oxidative stress in alcoholic and non-alcoholic liver disease. In Steatohepatitis (NASH and ASH). U Leuschner, OFW James, H Dancygier, (eds). Norwell, Kluwer Academic Publishers, 2001, pp 54-61

    Google Scholar 

  23. Sheth SG, Gordon FD, Chopra S: Nonalcoholic steatohepatitis. Ann Intern Med 126:137-145, 1997

    Google Scholar 

  24. Esterbauer H, Shaur RJ, Zollner H: Chemistry and biochemistry of 4-hydroxynonenal, malondialdeyde and related aldeydes. Free Radic Bio Med 11:81-128, 1991

    Google Scholar 

  25. Neuschwander-Tetri BA, Roll FJ: Chemotatic activity for human PMN generated during ethanol metabolism by rat hepatocytes: role of glutathione and glutathione peroxidase. Biophys Res Commun 167:1170-1176, 1990

    Google Scholar 

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Authors and Affiliations

  1. The Department of Medicine 2, Department of Pathology, and Center of Nutrition and Metabolism FMUL, IMM, University Hospital of Santa Maria, Lisbon, Portugal

    Helena Cortez-Pinto, Amélia Baptista, Maria Ermelinda Camilo & Miguel Carneiro de Moura

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  1. Helena Cortez-Pinto
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  2. Amélia Baptista
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  3. Maria Ermelinda Camilo
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  4. Miguel Carneiro de Moura
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Correspondence to Helena Cortez-Pinto.

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Cortez-Pinto, H., Baptista, A., Camilo, M.E. et al. Nonalcoholic Steatohepatitis—A Long-Term Follow-Up Study: Comparison with Alcoholic Hepatitis in Ambulatory and Hospitalized Patients. Dig Dis Sci 48, 1909–1913 (2003). https://doi.org/10.1023/A:1026152415917

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