Stickel, Felix; Seitz, Helmut K (2010). Alcoholic steatohepatitis. Best practice & research - clinical gastroenterology, 24(5), pp. 683-93. London: Baillière Tindall 10.1016/j.bpg.2010.07.003
Full text not available from this repository.Severe alcoholic steatohepatitis has a poor prognosis and is characterized by jaundice and signs of liver failure. Its incidence is unknown, but prevalence is around 20% in cohorts of alcoholics undergoing liver biopsy. Diagnosis is established with elevated liver transaminases, neutrophil counts, serum bilirubin, and impaired coagulation and a history of excessive alcohol consumption, and exclusion of other etiologies. Histology is helpful but not mandatory. Prognostic scores include the Maddrey's discriminant function, the model of end-stage liver disease, and the Glasgow Alcoholic Hepatitis Score. Pathophysiology involves hepatic fat storage, increased hepatic uptake of gut-derived endotoxins triggering Kupffer cell activation and release of proinflammatory triggers, induction of cytochrome P4502E1 producing toxic acetaldehyde and reactive oxygen species, and ethanol-mediated hyperhomocysteinemia causing endoplasmic reticulum stress. Treatment includes abstinence, enteral nutrition, corticosteroids, and possibly pentoxifylline. A debate is ongoing whether certain patients with severe alcoholic steatohepatitis could be eligible for liver transplantation.
Item Type: |
Journal Article (Original Article) |
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Division/Institute: |
04 Faculty of Medicine > Service Sector > Institute of Clinical Pharmacology and Visceral Research [discontinued] |
UniBE Contributor: |
Stickel, Felix |
ISSN: |
1521-6918 |
Publisher: |
Baillière Tindall |
Language: |
English |
Submitter: |
Factscience Import |
Date Deposited: |
04 Oct 2013 14:11 |
Last Modified: |
05 Dec 2022 14:01 |
Publisher DOI: |
10.1016/j.bpg.2010.07.003 |
PubMed ID: |
20955970 |
Web of Science ID: |
000284859300015 |
URI: |
https://boris.unibe.ch/id/eprint/1725 (FactScience: 203664) |