[Severe acute alcoholic hepatitis]

Presse Med. Jul-Aug 2018;47(7-8 Pt 1):655-666. doi: 10.1016/j.lpm.2018.05.013. Epub 2018 Jul 19.
[Article in French]

Abstract

All chronic and excessive consumer of alcohol with recent jaundice should be assessed using a Maddrey's score for severe acute alcoholic hepatitis. Corticosteroids are the first line of treatment, associated with an appropriate nutritional support and alcohol abstinence. Corticosteroids plus N-acetylcysteine combination improves short-term survival over corticosteroids alone, and could be proposed as a first line therapy. The response to treatment is evaluated at the 7th day of treatment, with the Lille model≤0.45. Prognostic of non-responders to corticosteroids with Lille model>0.45 is dramatically low with 23% survival at 6 month. Early liver transplantation in a selected group of patients with non-response to corticosteroids significantly improves 6th month and long-term survival.

Publication types

  • Review

MeSH terms

  • Acute Disease*
  • Algorithms
  • Hepatitis, Alcoholic* / diagnosis
  • Hepatitis, Alcoholic* / physiopathology
  • Hepatitis, Alcoholic* / therapy
  • Humans
  • Prognosis
  • Severity of Illness Index