Acute alcoholic hepatitis
Background
Acute alcoholic hepatitis is inflammatory liver disease secondary to alcohol use. Acute alcoholic hepatitis develops over weeks to months and patients typically have a history of heavy alcohol use for years(1). Alcoholic hepatitis Patients drink roughly 80 grams of ethanol daily for 5 years (2). Patients may present with many nonspecific complaints and the disease may be difficult to diagnose.
Alcohol hepatitis is often precipitated by an increase in alcohol intake after years of alcohol abuse (1).
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).
Differential Diagnosis
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
Disposition
See Also
External Links
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.