Related Experiment Videos
Alcoholic Hepatitis
1Division of Digestive Diseases, University of California at Los Angeles School of Medicine, 10945 Le Conte Avenue, 2114 PVUB, Los Angeles, CA 90095-6949, USA. shbhan@ucla.edu
Insights
Severe alcoholic hepatitis has a high mortality rate. While alcohol abstinence and supportive care are primary treatments, corticosteroids may benefit some patients, and pentoxifylline can improve short-term survival.
Area of Science:
- Hepatology
- Gastroenterology
- Internal Medicine
Background:
- Alcoholic hepatitis is a severe, multisystem disease from chronic alcohol abuse.
- High mortality rates are associated with severe cases, with up to 50% mortality within one month of hospitalization.
- Current primary management involves alcohol abstinence and supportive care.
Purpose of the Study:
- To review the current therapeutic strategies for alcoholic hepatitis.
- To evaluate the efficacy of various pharmacologic and non-pharmacologic interventions.
- To discuss the role of liver transplantation and extracorporeal support.
Main Methods:
- Literature review of studies on alcoholic hepatitis treatment.
- Analysis of evidence for corticosteroids, pentoxifylline, and other agents.
- Assessment of nutritional support, liver transplantation, and artificial liver support systems.
Main Results:
- Corticosteroids show benefit in severe cases with hepatic encephalopathy.
- Pentoxifylline improves short-term survival rates.
- Other interventions like colchicine, propylthiouracil, and nutritional support have not demonstrated efficacy.
Conclusions:
- Complete alcohol abstinence and supportive care remain the cornerstone of treatment.
- Pharmacologic options like corticosteroids and pentoxifylline offer specific benefits for select patients.
- Liver transplantation and extracorporeal devices are currently experimental or controversial for alcoholic hepatitis.
Abstract:
Alcoholic hepatitis is a multisystem disease seen in individuals who chronically abuse alcohol. When severe, it is associated with a very high mortality rate, with nearly 50% of severely affected persons dying within 1 month of hospitalization. Primary therapy is complete alcohol abstinence and supportive care. Corticosteroids have been shown to be beneficial in a subset of severely ill patients with alcoholic hepatitis and concomitant hepatic encephalopathy. Pentoxifylline has been shown to improve short-term survival rates. Other pharmacologic interventions, including colchicine, propylthiouracil, calcium channel antagonists, and insulin with glucagon infusions, have not been proven to be beneficial. Nutritional supplementation with high-calorie, high-protein diets does not improve mortality rates. Orthotopic liver transplantation is highly controversial in this population of patients and currently is not indicated as definitive treatment. Extracorporeal liver support devices are still in their developmental stage and are only experimental.