Alcoholic steatohepatitis

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)
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)