Gastroenterology Book

Cirrhosis

Hepatitis

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Alcoholic Hepatitis

Aka: Alcoholic Hepatitis, Alcoholic Liver Disease
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  1. Pathophysiology
    1. Precursor to Cirrhosis
    2. Characteristics
      1. Hepatocyte Inflammation, degeneration, and necrosis
      2. Neutrophil and Lymphocyte infiltration
  2. Epidemiology
    1. Alcoholic Hepatitis seen in 33% of chronic Alcoholics
  3. Symptoms
    1. Anorexia
    2. Nausea and Vomiting
    3. Weight loss
    4. Fever
    5. Generalized Abdominal Pain
  4. Signs
    1. Tender Hepatomegaly (80-90% of cases)
    2. Jaundice
    3. Ascites
    4. Splenomegaly
    5. Spider angioma
  5. Labs
    1. Aspartate Aminotransferase (AST) increased to 100-300
      1. AST to ALT ratio = 2:1
    2. Alkaline Phosphatase elevated
    3. Gamma glutamyl transferase (GGT) markedly elevated
    4. Hypoalbuminemia
    5. Prolonged ProTime
    6. Mean Corpuscular Volume (MCV) elevated
  6. Management
    1. See Prevention of Liver Disease Progression
    2. Alcohol Cessation
    3. Alcohol Withdrawal protocol
    4. Increased caloric and protein intake
    5. Vitamin supplementation
      1. Thiamine
      2. Folate
      3. Multivitamin
    6. Corticosteroids (Prednisolone)
      1. Efficacy: Improves survival (n=61)
        1. Two month survival 88% versus 45% with Placebo
        2. Improved survival persists for 1 year
        3. No advantage after 1 year
      2. References
        1. Mathurin (1996) Gastroenterology 110:1847-53
  7. Prognosis
    1. Mortality 10-15% from acute hepatitis
    2. Cirrhosis develops in 50% of Alcoholic Hepatitis
  8. References
    1. Hill (1998) Postgrad Med 103(4):261-275

Hepatitis, Alcoholic (C0019187)

Definition (MSH) INFLAMMATION of the LIVER due to ALCOHOL ABUSE. It is characterized by NECROSIS of HEPATOCYTES, infiltration by NEUTROPHILS, and deposit of MALLORY BODIES. Depending on its severity, the inflammatory lesion may be reversible or progress to LIVER CIRRHOSIS.
Definition (CSP) acute or chronic degenerative and inflammatory lesion of the liver in the alcoholic which is potentially progressive though sometimes reversible; it does not necessarily include steatosis, fibrosis, or cirrhosis of the liver, although it is frequently associated with these conditions; it is characterized by liver cell necrosis, infiltration by polymorphonuclear leukocytes and lymphocytes, and Mallory bodies.
Concepts Disease or Syndrome (T047)
MSH D006519
ICD10 K70.1
SnomedCT 197312006, 235875008
English Alcoholic Hepatitis, Hepatitis, Alcoholic, ALCOHOLIC HEPATITIS, HEPATITIS, ALCOHOLIC, alcoholic hepatitis (diagnosis), alcoholic hepatitis, Hepatitis alcoholic, HEPATITIS ALCOHOLIC, Hepatitis, Alcoholic [Disease/Finding], Hepatitis;alcoholic, hepatitis alcohol, alcoholics hepatitis, alcohol hepatitis, hepatitis alcoholic, Alcoholic hepatitis, AH - Alcoholic hepatitis, Alcoholic hepatitis (disorder), ethanol; hepatitis, hepatitis; alcoholic, hepatitis; ethanol, alcohol; hepatitis
Italian Epatite alcoolica, Epatite alcolica
Dutch alcoholische hepatitis, alcohol; hepatitis, ethanol; hepatitis, hepatitis; alcoholisch, hepatitis; ethanol, hepatitis door alcoholgebruik, Alcoholhepatitis, Alcoholische hepatitis, Hepatitis, alcoholische
Swedish Hepatit, alkoholbetingad
Japanese ｱﾙｺｰﾙｾｲｶﾝｴﾝ, アルコール性肝炎, 肝炎-アルコール性
Czech hepatitida alkoholická, Alkoholická hepatitida
Spanish Alcoholic hepatitis, hepatitis alcohólica (trastorno), hepatitis alcohólica, Hepatitis alcohólica, Hepatitis Alcohólica, Hepatitis Alcoholica
Finnish Alkoholimaksatulehdus
Russian ALKOGOL'NYI GEPATIT, GEPATIT ALKOGOL'NYI KHRONICHESKII, GEPATIT ALKOGOL'NYI, АЛКОГОЛЬНЫЙ ГЕПАТИТ, ГЕПАТИТ АЛКОГОЛЬНЫЙ, ГЕПАТИТ АЛКОГОЛЬНЫЙ ХРОНИЧЕСКИЙ
German Alkoholische Hepatitis, Hepatitis alkoholisch, Alkoholhepatitis, Hepatitis, alkoholische
Korean 알코올성 간염
Polish Zapalenie wątroby alkoholowe
Hungarian Alkoholos májgyulladás, Alkoholos hepatitis
Portuguese Hepatite alcoólica, Hepatite Alcoólica
French Hépatite alcoolique, Hépatite éthylique
Sources
Derived from the NIH UMLS (Unified Medical Language System)


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