Grand Rounds: Alcoholic Hepatitis

Journal of Hepatology
Ashwani K SingalPatrick S Kamath

Abstract

A 33-year-old Caucasian male was admitted to hospital with recent onset of jaundice of 2-3 weeks duration. He reported heavy use of alcohol for the last 10 years with the last drink a day prior to the onset of symptoms. At admission, he was alert and oriented to time, place, and person, and was deeply jaundiced. His laboratory profile can be summarised as follows: haemoglobin 12.1 g/dl, white blood cell count 18,700 with 81% neutrophils, serum bilirubin 33 (direct 22) mg/dl, aspartate aminotransferase 147 IU/L, alanine aminotransferase 62 IU/L, alkaline phosphatase 117 IU/L, serum albumin 2.8 gm/dl, serum creatinine 0.6 mg/dl, prothrombin time 18.3 (control 14.5) seconds, and international normalized ratio 1.48. He was diagnosed with severe alcoholic hepatitis (Maddrey discriminant function score of 50) and treated with prednisolone for 28 days with symptomatic and biochemical improvement. His Lille score at seven days was 0.4, and his serum bilirubin had decreased to 3.5 mg/dl at the end of treatment. He was also seen by the addiction team during hospitalisation; he agreed to follow through on recommendations. He was dismissed after completing a three-week inpatient rehabilitation programme but relapsed to alcohol use three mo...Continue Reading

Citations

Oct 12, 2018·Minerva gastroenterologica e dietologica·Pierluigi ToniuttoElisa Fumolo
Mar 28, 2020·United European Gastroenterology Journal
Nov 28, 2019·Hepatology : Official Journal of the American Association for the Study of Liver Diseases·Juan P ArabVijay H Shah
Jan 10, 2020·Journal of Clinical and Translational Hepatology·Cyriac Abby PhilipsPhilip Augustine
Jun 18, 2020·World Journal of Hepatology·Andre Castro LyraLourianne Nascimento Cavalcante
Apr 5, 2020·Hepatology : Official Journal of the American Association for the Study of Liver Diseases·Tejasav S SehrawatHarmeet Malhi
Oct 19, 2019·Pharmacology & Therapeutics·Edward D ChanPaul E Marik
Jul 8, 2021·Clinics in Liver Disease·Juan Pablo ArabAshwani K Singal
Jul 14, 2021·JAMA : the Journal of the American Medical Association·Ashwani K Singal, Philippe Mathurin
Nov 25, 2021·Daru : Journal of Faculty of Pharmacy, Tehran University of Medical Sciences·Jiuqin ZhouYongzhen Zhai
Jan 7, 2022·Indian Journal of Gastroenterology : Official Journal of the Indian Society of Gastroenterology·Cyriac Abby PhilipsSuchetha M Jagan
Jan 19, 2022·Zeitschrift für Gastroenterologie·Jonel TrebickaRichard Moreau

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