Acute alcoholic hepatitis

Background

Acute alcoholic hepatitis is inflammatory liver disease secondary to alcohol use.

• spectrum from hepatic steatosis to alcoholic hepatitis to cirrhosis
• history of (usually chronic) alcohol abuse (~80 grams of ethanol daily for 5 years (2))
• ranges from subclinical cases to severe multisystem dysfunction

Clinical Features

Jaundice, Hepatomegaly, ascites, fever, GI bleed, malnutrition, Varicies, abdominal pain, nausea, vomiting, anorexia, hepatorenal syndrome, hepatic encephalopathy, hepatic bruit, alcohol withdrawal(2).

Cirrhosis is found in 50-60% of cases of alcoholic hepatitis (2).

Diagnosis

Diagnosis is difficult and relies on a good history (1). Laboratory analysis may find an AST/ALT ratio of >1.5, elevated GGT, elevated WBC (1).

Management

Abstinence from alcohol, nutritional supplementation (thiamine, folate

References

1. Amini, Maziyar; Runyon, Bruce. "Alcoholic Hepatitis 2010: A clinician's Guide to Diagnosis and Therapy." World of Gatstroenterol 2010 October 21; 16(39):4905-4912
2. Basra, Gurjot,et. al. "Symptoms and Signs of Acute Alcoholic Hepatitis." World J Hepatol. 2011 May 27; 3(5): 118–120.