Acute Alcoholic Hepatitis

Clin Liver Dis. 2019 Feb;23(1):81-98. doi: 10.1016/j.cld.2018.09.005. Epub 2018 Oct 26.

Abstract

Alcoholic hepatitis is a unique type of alcohol-associated liver disease characterized by acute liver inflammation caused by prolonged heavy alcohol use. Treatment is mostly supportive. The short-term prognosis of acute alcoholic hepatitis depends on liver recovery, and ranges widely from rapid improvement to grim multiorgan failure despite treatment. Refinement of scoring systems have enhanced prognostication to guide clinical decision making in alcoholic hepatitis. Recent advances in the treatment of alcoholic hepatitis have solidified corticosteroids as the cornerstone of treatment to enhance short-term survival, but not intermediate or long-term survival.

Keywords: Alcohol use disorder; Alcoholic hepatitis; Corticosteroids; Discriminant function; Hepatorenal syndrome; Lille score; N-acetylcysteine; Pentoxifylline.

Publication types

  • Review

MeSH terms

  • Acute Disease
  • Alanine Transaminase / metabolism*
  • Aspartate Aminotransferases / metabolism*
  • Biopsy
  • Elasticity Imaging Techniques
  • Glucocorticoids / therapeutic use
  • Hepatitis, Alcoholic / diagnosis
  • Hepatitis, Alcoholic / drug therapy
  • Hepatitis, Alcoholic / metabolism*
  • Hepatitis, Alcoholic / pathology
  • Humans
  • Jaundice / metabolism*
  • Liver / pathology
  • Prednisolone / therapeutic use
  • Prognosis
  • Severity of Illness Index

Substances

  • Glucocorticoids
  • Prednisolone
  • Aspartate Aminotransferases
  • Alanine Transaminase