Prognosis and treatment of patients with acute alcoholic hepatitis.

Abstract

Despite alcoholic hepatitis (AH) is the most acute manifestation of alcohol-related liver disease, its treatment remains controversial. Corticosteroids, given either as monotherapy or together with N-acetylecysteine, have been associated with a moderate short-term survival benefit in patients with severe disease. The Maddrey's discriminant function; Glasgow alcoholic hepatitis score; age, bilirubin, INR and creatinine score; and the Model for end-stage liver disease have been proposed for stratifying prognosis in AH enabling selection of the patients to treat. Definition of treatment non-responders using the Lille model after 7 days of therapy may prevent a detrimental impact of prolonged corticosteroids. Pentoxifylline is an effective alternative reducing the occurrence of hepatorenal syndrome. Emerging evidence supports use of liver transplantation in a strictly selected subset of corticosteroid non-responders.

• Authors: Vassilios Papastergiou, Andrew K Burroughs, Emmanuel A Tsochatzis
• Journal: Expert review of gastroenterology & hepatology (Expert Rev Gastroenterol Hepatol) Vol. 8 Issue 5 Pg. 471-86 (Jul 2014) ISSN: 1747-4132 [Electronic] England
• PMID: 24716632 (Publication Type: Journal Article, Review)

Chemical References

• Adrenal Cortex Hormones
• Antioxidants
• Phosphodiesterase Inhibitors
• Pentoxifylline
• Acetylcysteine

Topics

• Acetylcysteine (therapeutic use)
• Acute Disease
• Adrenal Cortex Hormones (therapeutic use)
• Antioxidants (therapeutic use)
• Drug Resistance
• Drug Therapy, Combination
• Hepatitis, Alcoholic (complications, diagnosis, mortality, therapy)
• Hepatorenal Syndrome (etiology, prevention & control)
• Humans
• Liver Transplantation (adverse effects, mortality)
• Patient Selection
• Pentoxifylline (therapeutic use)
• Phosphodiesterase Inhibitors (therapeutic use)
• Risk Factors
• Severity of Illness Index
• Treatment Outcome