Alcoholic steatohepatitis
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, s...
Gespeichert in:
| Hauptverfasser: | , |
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| Dokumenttyp: | Article (Journal) |
| Sprache: | Englisch |
| Veröffentlicht: |
October 2010
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| In: |
Best practice & research. Clinical gastroenterology
Year: 2010, Jahrgang: 24, Heft: 5, Pages: 683-693 |
| ISSN: | 1532-1916 |
| DOI: | 10.1016/j.bpg.2010.07.003 |
| Online-Zugang: | Verlag, lizenzpflichtig, Volltext: https://doi.org/10.1016/j.bpg.2010.07.003 Verlag, lizenzpflichtig, Volltext: https://www.sciencedirect.com/science/article/pii/S152169181000082X 
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| Verfasserangaben: | Felix Stickel, Helmut K. Seitz |
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| 520 | |a 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. | ||
| 650 | 4 | |a Acetaldehyde | |
| 650 | 4 | |a Alcoholic hepatitis | |
| 650 | 4 | |a Corticosteroids | |
| 650 | 4 | |a Endotoxins | |
| 650 | 4 | |a Enteral nutrition | |
| 650 | 4 | |a Liver failure | |
| 650 | 4 | |a Liver transplantation | |
| 650 | 4 | |a Pentoxifylline | |
| 650 | 4 | |a Tumour necrosis factor | |
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