Alcoholic Hepatitis

44 y/o Male presents with progressive jaundice and hyperbilirubinemia after last drink 6 weeks prior. Following exclusion of an obstructive process the likely etiology was determined to be alcoholic hepatitis. This patient did not feel much sicker than usual but by validtaed scoring tools, had a 30 day mortality > 40%. The review article below discusses the inflammatory cascade that promotes progressive liver injury in these patients and subsequently discusses the utility of various interventions. Most importantly steroids and enteral nutrition.

Alcoholic Hepatitis – great review in NEJM

The Lille model: a new tool for therapeutic strategy in patients with severe alcoholic hepatitis treated with steroids. Scoring tool for assessing utility of steroids 1 week into treatment.

The Glasgow alcoholic hepatitis score identifies patients who may benefit from corticosteroids. A paper that discusses mortality benefit with steroid-use in a select group of patients with alcoholic hepatitis.