Tags

Type your tag names separated by a space and hit enter

Review article: the diagnosis and management of alcoholic hepatitis.
Aliment Pharmacol Ther. 2009 Jul; 30(1):3-13.AP

Abstract

BACKGROUND

Alcoholic hepatitis is a severe, cholestatic liver disease occurring in patients with alcohol abuse. Mortality is substantial; however, therapies may improve clinical outcomes.

AIM

To provide an updated review of the epidemiology, diagnosis, staging and treatment of alcoholic hepatitis.

METHODS

A MEDLINE literature search was performed to identify pertinent articles. Relevant clinical abstracts were also reviewed.

RESULTS

Severe alcoholic hepatitis occurs in a small fraction of patients who abuse alcohol. The 28-day mortality ranges from 30% to 50% in most series. Diagnosis is generally based on clinical features, with a limited role for liver biopsy. Beneficial treatment options include alcohol abstinence and nutritional therapy. Despite variable results in clinical trials, corticosteroids and pentoxifylline appear to provide moderate survival benefit. Anti-tumour necrosis factor agents and antioxidants have not proven beneficial, and should be limited to clinical trials. Liver transplant is not a frequent option given the active or recent alcohol use.

CONCLUSIONS

Severe alcoholic hepatitis is a clinically-diagnosed condition associated with significant mortality. Alcohol abstinence and nutritional therapy have been associated with improved clinical parameters and should be considered in all patients. Corticosteroid therapy and pentoxifylline therapy appear to show moderate survival benefit and should be considered as first-line therapeutic agents.

Authors+Show Affiliations

Section of Hepatology, Rush University Medical Center, Chicago, IL 60612, USA. stanley_m_cohen@rush.eduNo affiliation info available

Pub Type(s)

Journal Article
Review

Language

eng

PubMed ID

19416132

Citation

Cohen, S M., and J Ahn. "Review Article: the Diagnosis and Management of Alcoholic Hepatitis." Alimentary Pharmacology & Therapeutics, vol. 30, no. 1, 2009, pp. 3-13.
Cohen SM, Ahn J. Review article: the diagnosis and management of alcoholic hepatitis. Aliment Pharmacol Ther. 2009;30(1):3-13.
Cohen, S. M., & Ahn, J. (2009). Review article: the diagnosis and management of alcoholic hepatitis. Alimentary Pharmacology & Therapeutics, 30(1), 3-13. https://doi.org/10.1111/j.1365-2036.2009.04002.x
Cohen SM, Ahn J. Review Article: the Diagnosis and Management of Alcoholic Hepatitis. Aliment Pharmacol Ther. 2009;30(1):3-13. PubMed PMID: 19416132.
* Article titles in AMA citation format should be in sentence-case
TY - JOUR T1 - Review article: the diagnosis and management of alcoholic hepatitis. AU - Cohen,S M, AU - Ahn,J, Y1 - 2009/03/26/ PY - 2009/5/7/entrez PY - 2009/5/7/pubmed PY - 2010/2/23/medline SP - 3 EP - 13 JF - Alimentary pharmacology & therapeutics JO - Aliment. Pharmacol. Ther. VL - 30 IS - 1 N2 - BACKGROUND: Alcoholic hepatitis is a severe, cholestatic liver disease occurring in patients with alcohol abuse. Mortality is substantial; however, therapies may improve clinical outcomes. AIM: To provide an updated review of the epidemiology, diagnosis, staging and treatment of alcoholic hepatitis. METHODS: A MEDLINE literature search was performed to identify pertinent articles. Relevant clinical abstracts were also reviewed. RESULTS: Severe alcoholic hepatitis occurs in a small fraction of patients who abuse alcohol. The 28-day mortality ranges from 30% to 50% in most series. Diagnosis is generally based on clinical features, with a limited role for liver biopsy. Beneficial treatment options include alcohol abstinence and nutritional therapy. Despite variable results in clinical trials, corticosteroids and pentoxifylline appear to provide moderate survival benefit. Anti-tumour necrosis factor agents and antioxidants have not proven beneficial, and should be limited to clinical trials. Liver transplant is not a frequent option given the active or recent alcohol use. CONCLUSIONS: Severe alcoholic hepatitis is a clinically-diagnosed condition associated with significant mortality. Alcohol abstinence and nutritional therapy have been associated with improved clinical parameters and should be considered in all patients. Corticosteroid therapy and pentoxifylline therapy appear to show moderate survival benefit and should be considered as first-line therapeutic agents. SN - 1365-2036 UR - https://www.unboundmedicine.com/medline/citation/19416132/Review_article:_the_diagnosis_and_management_of_alcoholic_hepatitis_ L2 - https://doi.org/10.1111/j.1365-2036.2009.04002.x DB - PRIME DP - Unbound Medicine ER -