Advertisement

Acute Alcoholic Hepatitis

  • Sasan Sakiani
  • Arthur McCulloughEmail author
Chapter

Abstract

Alcohol-induced liver disease is the leading cause of chronic liver disease worldwide and remains the second most common cause of cirrhosis in the United States. Heavy alcohol use, which is defined by more than three drinks per day for men and more than two drinks per day for women for over 5 years, can lead to a broad range of chronic liver diseases, including steatosis (60–100% of patients), steatohepatitis and fibrosis (20–40% of patients), and eventually cirrhosis (10–20% of patients) and hepatocellular carcinoma (3–10%). Acute alcoholic hepatitis (AH) is a clinical diagnosis that is based on the development of jaundice and hepatocellular injury that occurs in 35–40% of patients with heavy alcohol use and has been associated with 20–50% mortality in untreated patients. In this chapter, we describe a case of a patient presenting with severe AH. We discuss diagnosis, prognosis, treatment options, and outcomes.

Keywords

Acute alcoholic hepatitis Alcoholic hepatitis Alcoholic liver disease Corticosteroids Maddrey discriminant function MELD score Liver transplant 

Further Reading

  1. 1.
    Drinane MC, Shah VH. Alcoholic hepatitis: diagnosis and prognosis. Clin Liver Dis. 2013;2(2):80–3.CrossRefGoogle Scholar
  2. 2.
    Garcia-Saenz-de-Sicilia M, Duvoor C, Altamirano J, Chavez-Araujo R, Prado V, de Lourdes C-MA, et al. A Day-4 Lille model predicts response to corticosteroids and mortality in severe alcoholic hepatitis. Am J Gastroenterol. 2017;112(2):306–15.CrossRefGoogle Scholar
  3. 3.
    Lucey MR. Liver transplantation for alcoholic liver disease. Nat Rev Gastroenterol Hepatol. 2014;11(5):300–7.CrossRefGoogle Scholar
  4. 4.
    Mathurin P, Moreno C, Samuel D, Dumortier J, Salleron J, Durand F, et al. Early liver transplantation for severe alcoholic hepatitis. N Engl J Med. 2011;365(19):1790–800.CrossRefGoogle Scholar
  5. 5.
    Mendenhall C, Roselle GA, Gartside P, Moritz T. Relationship of protein calorie malnutrition to alcoholic liver disease: a reexamination of data from two veterans administration cooperative studies. Alcohol Clin Exp Res. 1995;19(3):635–41.CrossRefGoogle Scholar
  6. 6.
    Singal AK, Bataller R, Ahn J, Kamath PS, Shah VH. ACG clinical guideline: alcoholic liver disease. Am J Gastroenterol. 2018;113(2):175–94.CrossRefGoogle Scholar
  7. 7.
    Thursz MR, Richardson P, Allison M, Austin A, Bowers M, Day CP, et al. Prednisolone or pentoxifylline for alcoholic hepatitis. N Engl J Med. 2015;372(17):1619–28.CrossRefGoogle Scholar

Copyright information

© Springer Nature Switzerland AG 2019

Authors and Affiliations

  1. 1.Department of Gastroenterology and HepatologyDigestive Disease Institute, Cleveland ClinicClevelandUSA
  2. 2.Lerner College of Medicine at Case Western Reserve UniversityClevelandUSA

Personalised recommendations