alcoholic hepatitis


Summary: INFLAMMATION of the LIVER due to ALCOHOL ABUSE. It is characterized by NECROSIS of HEPATOCYTES, infiltration by NEUTROPHILS, and deposit of MALLORY BODIES. Depending on its severity, the inflammatory lesion may be reversible or progress to LIVER CIRRHOSIS.

Top Publications

  1. Jalan R, Sen S, Steiner C, Kapoor D, Alisa A, Williams R. Extracorporeal liver support with molecular adsorbents recirculating system in patients with severe acute alcoholic hepatitis. J Hepatol. 2003;38:24-31 pubmed
    The mortality of patients with severe acute alcoholic hepatitis (AH) remains high, leading to interest in the use of extracorporeal liver support...
  2. Mathurin P, Mendenhall C, Carithers R, Ramond M, Maddrey W, Garstide P, et al. Corticosteroids improve short-term survival in patients with severe alcoholic hepatitis (AH): individual data analysis of the last three randomized placebo controlled double blind trials of corticosteroids in severe AH. J Hepatol. 2002;36:480-7 pubmed
    Controversy surrounding the efficacy of corticosteroids in severe alcoholic hepatitis (AH) persists...
  3. Singal A, Shah V. Therapeutic Strategies for the Treatment of Alcoholic Hepatitis. Semin Liver Dis. 2016;36:56-68 pubmed publisher
    Acute alcoholic hepatitis is a unique clinical syndrome among patients with chronic and active heavy alcohol use...
  4. Scallion R, Wei J. Upper gastrointestinal hemorrhage from a Mallory-Weiss tear associated with an occult Richter's hernia and small bowel obstruction: to see the forest as well as the trees in the emergency department. J Emerg Med. 1994;12:463-6 pubmed
    ..We report an unusual condition presenting with a Mallory-Weiss tear, a small bowel obstruction resulting from an occult Richter's hernia, which was not suspected or diagnosed at initial presentation. ..
  5. Angulo P. [Cholestatic syndromes]. Rev Gastroenterol Mex. 2005;70 Suppl 3:45-51 pubmed
  6. Chung N, Kwon O, Park C, Kim Y, Cho G, Lee J, et al. [A comparative cross-sectional study of the development of hepatocellular carcinoma in patients with liver cirrhosis caused by hepatitis B virus, alcohol, or combination of hepatitis b virus and alcohol]. Korean J Gastroenterol. 2007;49:369-75 pubmed
    ..Chronic alcohol intake may be an additive factor for the development of HCC in patient with LC caused by HBV. However, a prospective cohort study is needed to confirm these findings. ..
  7. Lefkowitch J. Morphology of alcoholic liver disease. Clin Liver Dis. 2005;9:37-53 pubmed
    ..been well described, and include three major lesions: steatosis (fatty liver), steatohepatitis (formerly alcoholic hepatitis), and cirrhosis...
  8. Mookerjee R, Sen S, Davies N, Hodges S, Williams R, Jalan R. Tumour necrosis factor alpha is an important mediator of portal and systemic haemodynamic derangements in alcoholic hepatitis. Gut. 2003;52:1182-7 pubmed
    ..that tumour necrosis factor alpha (TNF-alpha) is an important mediator of the circulatory disturbances in alcoholic hepatitis (AH) and evaluates the acute and short term effect of a single infusion of the monoclonal chimeric anti-TNF-..
  9. Lucey M. Is liver transplantation an appropriate treatment for acute alcoholic hepatitis?. J Hepatol. 2002;36:829-31 pubmed

More Information


  1. Shetty S, Venkatakrishnan L, Krishanveni J, Kumari S. Transjugular liver biopsy in severe alcoholic hepatitis. Indian J Gastroenterol. 2017;36:23-26 pubmed publisher
    b>Alcoholic hepatitis and cirrhosis although part of spectrum of alcoholic liver disease can have overlapping features, and differentiating them using clinical, biochemical, and imaging features is not always possible...
  2. Niu X, He L, Fan T, Li Y. [Protecting effect of brevifolin and 8,9-single-epoxy brevifolin of Phyllanthus simplex on rat liver injury]. Zhongguo Zhong Yao Za Zhi. 2006;31:1529-32 pubmed
    ..Brevifolin and 8,9-single-epoxy brevifolin show protective effective against acute and chronic liver injuries, and the mechanism is relevant to antagonizing the lipid peroxidation of free radical and improving the blood circulation. ..
  3. Braham A, Safer L, Bdioui F, Lejmi A, Brahmi I, Ben Chabenne N, et al. [Antiphospholipid antibodies in digestive diseases]. Presse Med. 2001;30:1890-7 pubmed
    ..Due to the diversity of these antibodies, it is unlikely that a unique mechanism could explain all the different thrombotic manifestations associated with their presence. ..
  4. Klammt S, Stange J, Mitzner S, Peszynski P, Peters E, Liebe S. Extracorporeal liver support by recirculating albumin dialysis: analysing the effect of the first clinically used generation of the MARSystem. Liver. 2002;22 Suppl 2:30-4 pubmed
    ..The elimination of albumin bound and water soluble substances was accompanied by an improvement of clinical status. ..
  5. Sugimoto M, Sadamoto T, Nonaka H. Clinical and pathological differences between alcoholic hepatitis and non-alcoholic steatohepatitis. Nihon Arukoru Yakubutsu Igakkai Zasshi. 2003;38:34-45 pubmed
    To determine the difference between alcoholic hepatitis (AH) and non-alcoholic steatohepatitis (NASH) in Japan, six patients with Ah and four patients with NASH, recently treated at our institute, were clinically and pathologically ..
  6. Sougioultzis S, Dalakas E, Hayes P, Plevris J. Alcoholic hepatitis: from pathogenesis to treatment. Curr Med Res Opin. 2005;21:1337-46 pubmed
    b>Alcoholic hepatitis is a serious complication of alcohol abuse due to its high mortality rates particularly at short term...
  7. Brunt E, Tiniakos D. Pathology of steatohepatitis. Best Pract Res Clin Gastroenterol. 2002;16:691-707 pubmed
    ..This chapter will elucidate the constellation of microscopic findings, the issues of concern for pathological evaluation and the knowledge to date of their significance in various forms of fatty liver disease. ..
  8. Lucey M. Management of alcoholic liver disease. Clin Liver Dis. 2009;13:267-75 pubmed publisher
    ..To treat alcoholic liver injury, corticosteroids have become the standard of care in patients with severe alcoholic hepatitis. In contrast, the role of pharmacotherapy to treat alcoholic fibrosis is unclear, with failure to observe a ..
  9. Maruyama K, Takahashi H, Okuyama K, Yokoyama A, Nakamura Y, Kobayashi Y, et al. Low serum amylase levels in drinking alcoholics. Alcohol Clin Exp Res. 2003;27:16S-21S pubmed
    ..Measurement of total serum amylase is not appropriate for diagnosing pancreatitis in alcoholic patients or those who consume large quantities of alcohol. ..
  10. Purohit V, Russo D. Cellular and molecular mechanisms of alcoholic hepatitis: introduction and summary of the symposium. Alcohol. 2002;27:3-6 pubmed
    ..Institutes of Health, sponsored a satellite symposium on "Cellular and Molecular Mechanisms of Alcoholic Hepatitis" at the 24th Annual Scientific Meeting of the Research Society on Alcoholism, Montreal, Quebec, Canada,..
  11. Xu M, Chang B, Mathews S, Gao B. New drug targets for alcoholic liver disease. Hepatol Int. 2014;8 Suppl 2:475-80 pubmed publisher
    Alcoholic liver disease (ALD) represents a spectrum of disorders, ranging from simple steatosis to severe alcoholic hepatitis and cirrhosis...
  12. Momen Heravi F, Saha B, Kodys K, Catalano D, Satishchandran A, Szabo G. Increased number of circulating exosomes and their microRNA cargos are potential novel biomarkers in alcoholic hepatitis. J Transl Med. 2015;13:261 pubmed publisher
    ..However, there is no potential biomarker to monitor the extent of liver injury in alcoholic hepatitis patients...
  13. O Keefee C, McCormick P. Severe acute alcoholic hepatitis: an audit of medical treatment. Ir Med J. 2002;95:108-9, 111 pubmed
    Despite advances in treatment, severe alcoholic hepatitis is still associated with a high mortality rate of 30% to 40%. Nutritional support and steroids in selected patients are believed to improve prognosis...
  14. Zenda T, Kobayashi T, Miyamoto S, Okada T. Severe alcoholic hepatitis accompanied by Fournier's gangrene. Eur J Gastroenterol Hepatol. 2003;15:419-22 pubmed
    ..infection of the external genitalia and perineum (Fournier's gangrene) occurred in a patient with severe alcoholic hepatitis. By means of radical débridement and disinfection of the necrotizing tissue, use of broad-spectrum ..
  15. Saikia P, Roychowdhury S, BELLOS D, Pollard K, McMullen M, McCullough R, et al. Hyaluronic acid 35 normalizes TLR4 signaling in Kupffer cells from ethanol-fed rats via regulation of microRNA291b and its target Tollip. Sci Rep. 2017;7:15671 pubmed publisher
    ..In peripheral blood monocytes isolated from patients with alcoholic hepatitis, expression of TNFα mRNA was robustly increased in response to challenge with lipopolysaccharide...
  16. Segado Soriano A, Santiago Dorrego C, Bañares Cañizares R, Alvarez Fernandez E, Bandrés Moya F, Gomez Gallego F. [Genetic susceptibility to the development of acute alcoholic hepatitis: role of genetic mutations in dehydrogenase alcohol, aldehyde dehydrogenase and cytochrome P450 2E1]. Rev Clin Esp. 2005;205:528-32 pubmed
    ..and cytochrome P450 2E1 (CYP2E1) and establish their possible association with the development of acute alcoholic hepatitis (AAH). Case-control study in a total of 85 Spanish patients...
  17. Ohtsuka T, Tsutsumi M, Fukumura A, Tsuchishima M, Takase S. Use of serum carbohydrate-deficient transferrin values to exclude alcoholic hepatitis from non-alcoholic steatohepatitis: a pilot study. Alcohol Clin Exp Res. 2005;29:236S-9S pubmed
    ..allow an accurate diagnosis of non-alcoholic steatohepatitis (NASH), the diagnosis by exclusion of alcoholic hepatitis is necessary...
  18. Dunn W, Shah V. Pathogenesis of Alcoholic Liver Disease. Clin Liver Dis. 2016;20:445-56 pubmed publisher
    ..liver disease includes a broad clinical-histological spectrum from simple steatosis, cirrhosis, acute alcoholic hepatitis with or without cirrhosis to hepatocellular carcinoma as a complication of cirrhosis...
  19. Mathurin S, Agüero A, Dascani N, Prestera J, Gianserra C, Londero E, et al. [Anemia in hospitalized patients with cirrhosis: prevalence, clinical relevance and predictive factors]. Acta Gastroenterol Latinoam. 2009;39:103-11 pubmed
    ..5 g/dl, infections, hepatic encephalopathy and alcoholic hepatitis also were predictive factors of moderate-severe anemia...
  20. Kharchenko N, Synyts kyĭ V, Kovtun T. [Comparative analysis of the effects of alcoholism and opium addiction on liver function]. Fiziol Zh. 2001;47:81-6 pubmed
    ..Destructive and metabolic changes increase in the liver in the patients with the second stage of narcomania. ..
  21. Sass D, Shaikh O. Alcoholic hepatitis. Clin Liver Dis. 2006;10:219-37, vii pubmed
    b>Alcoholic hepatitis is a form of hepatic injury that carries a significant morbidity and mortality. The clinical presentation is that of fatigue, malaise, and jaundice in individuals who have abused excessive quantities of alcohol...
  22. McErlean A, Looby S, Lee M. Percutaneous ultrasound-guided thrombin injection as first-line treatment of pancreatic pseudoaneurysm. Cardiovasc Intervent Radiol. 2007;30:526-8 pubmed
    ..In this report we present a case of a pseudoaneurysm secondary to pancreatitis which, despite being angiographically invisible, was successfully embolized with a single ultrasound-guided percutaneous injection of thrombin. ..
  23. Gholam P. Prognosis and Prognostic Scoring Models for Alcoholic Liver Disease and Acute Alcoholic Hepatitis. Clin Liver Dis. 2016;20:491-7 pubmed publisher
    Multiple prognostic scoring systems have been developed to predict mortality from acute alcoholic hepatitis. Some systems, such as the modified discriminant function, are specific to alcoholic hepatitis...
  24. Li J, Yang C, Zhang S, Liu S, Zhao L, Luo H, et al. Ginsenoside Rg1 inhibits inflammatory responses via modulation of the nuclear factor??B pathway and inhibition of inflammasome activation in alcoholic hepatitis. Int J Mol Med. 2017;: pubmed publisher
    ..investigate the protective effects of G?Rg1 on alcohol?induced cell injury in vitro and on a rat model of alcoholic hepatitis in vivo...
  25. Jha S, Jose M. Non-hypertensive intracerebral haemorrhage: some interesting observations. J Assoc Physicians India. 2006;54:485-7 pubmed
    ..We report three interesting cases of NHICH subsequent to amyloid angiopathy, alcoholic hepatitis and amphetamine abuse...
  26. Balasubramaniyan V, Nalini N. Effect of hyperleptinaemia on chronic ethanol-induced hepatotoxicity in mice. Fundam Clin Pharmacol. 2006;20:129-36 pubmed
    ..It is postulated that the increase in systemic leptin levels enhances oxidative stress, and lowers antioxidant defence, leading to the augmented hepatic inflammation observed in alcoholic liver disease. ..
  27. Colombat M, Charlotte F, Ratziu V, Poynard T. Portal lymphocytic infiltrate in alcoholic liver disease. Hum Pathol. 2002;33:1170-4 pubmed
    ..These results suggest that lymphocytes may play a role in the pathogenesis of alcohol-induced liver fibrosis. ..
  28. You S, Rong Y, Zhu B, Zhang A, Zang H, Liu H, et al. Changing etiology of liver failure in 3,916 patients from northern China: a 10-year survey. Hepatol Int. 2013;7:714-20 pubmed publisher
    ..5 %). Drug-induced liver injury, alcoholic hepatitis, and autoimmune hepatitis led to 120 cases (3.1 %), 109 cases (2.8 %), and 19 cases (0...
  29. Wegrzynek I, Zulikowska E. [Usefulness of enzyme tests, biochemical tests and ultrasonography for evaluation of hepatotoxic impact of ethanol]. Przegl Lek. 2001;58:301-5 pubmed
    ..The reference group comprised 30 healthy men, not exposed to hepatotoxic agents. The liver ultrasonography combined with biochemical analysis allows to assess the liver condition in alcoholics poisoned with ethanol. ..
  30. Gisbert J, Pajares J, Moreno Otero R. [Treatment of alcoholic hepatitis with corticosteroids. Are they really effective?]. Med Clin (Barc). 2002;119:590-5 pubmed
  31. Ponce Pérez L, Cárdenas Lailson L, Domínguez Muñoz G, López Díaz Y, Vera Rodríguez F. [Giant abscessed urachal cyst in adult. Case report]. Cir Cir. 2013;81:348-52 pubmed
    ..A 30-year-old male patient with a history of alcoholic hepatitis, diabetes mellitus type 2, chronic malnutrition, increased volume beginning with generalized abdominal pain,..
  32. Liu Y, Verma V, Malhi H, Gores G, Kamath P, Sanyal A, et al. Lipopolysaccharide downregulates macrophage-derived IL-22 to modulate alcohol-induced hepatocyte cell death. Am J Physiol Cell Physiol. 2017;313:C305-C313 pubmed publisher
    ..IL-22) is a Th17 cell hepatoprotective cytokine that is undergoing clinical trials to treat patients with alcoholic hepatitis (AH)...
  33. Wang J, Kim C, Jogasuria A, Han Y, Hu X, Wu J, et al. Myeloid Cell-Specific Lipin-1 Deficiency Stimulates Endocrine Adiponectin-FGF15 Axis and Ameliorates Ethanol-Induced Liver Injury in Mice. Sci Rep. 2016;6:34117 pubmed publisher
    ..Our novel data demonstrate that myeloid cell-specific deletion of lipin-1 ameliorated inflammation and alcoholic hepatitis in mice via activation of endocrine adiponectin-FGF15 signaling.
  34. Bautista A. Free radicals, chemokines, and cell injury in HIV-1 and SIV infections and alcoholic hepatitis. Free Radic Biol Med. 2001;31:1527-32 pubmed
  35. Batey R, Wang J. Molecular pathogenesis of T lymphocyte-induced liver injury in alcoholic hepatitis. Front Biosci. 2002;7:d1662-75 pubmed
    ..It suggested that liver-associated T lymphocytes are involved in the inflammatory process associated with alcohol related liver injury through increased cytokine secretion (TNF alpha). ..
  36. Atkinson S, Way M, McQuillin A, Morgan M, Thursz M. Homozygosity for rs738409:G in PNPLA3 is associated with increased mortality following an episode of severe alcoholic hepatitis. J Hepatol. 2017;67:120-127 pubmed publisher
    ..Short-term mortality in patients with severe alcoholic hepatitis is high; drinking behaviour is a major determinant of outcome in survivors...
  37. Louvet A, Naveau S, Abdelnour M, Ramond M, Diaz E, Fartoux L, et al. The Lille model: a new tool for therapeutic strategy in patients with severe alcoholic hepatitis treated with steroids. Hepatology. 2007;45:1348-54 pubmed
    Early identification of patients with severe (discriminant function > or = 32) alcoholic hepatitis (AH) not responding to corticosteroids is crucial...
  38. Ferrere G, Wrzosek L, Cailleux F, Turpin W, Puchois V, Spatz M, et al. Fecal microbiota manipulation prevents dysbiosis and alcohol-induced liver injury in mice. J Hepatol. 2017;66:806-815 pubmed publisher
    Alcoholic liver disease (ALD) is a leading cause of liver failure and mortality. In humans, severe alcoholic hepatitis is associated with key changes to intestinal microbiota (IM), which influences individual sensitivity to develop ..
  39. Testino G, Leone S. Acute alcoholic hepatitis: a literature review and proposal of treatment. Minerva Med. 2018;109:290-299 pubmed publisher
    Severe acute alcoholic hepatitis (AAH) can lead to a clinical picture with a six-month mortality rate in more than 70% of cases...
  40. Neuberger J. An update on liver transplantation: A critical review. J Autoimmun. 2016;66:51-9 pubmed publisher
    ..Recent studies have shown that selected patients with severe alcoholic hepatitis may also benefit from liver transplant...
  41. Miyano S, Maeyama S, Iwaba A, Ogata S, Koike J, Kishi M, et al. A clinicopathological study of acute hepatitis in heavy drinkers, unrelated to hepatitis A, B, or C viruses. Alcohol Clin Exp Res. 2001;25:69S-74S pubmed
    ..It seems natural to consider that these cases are developed by other, unknown causes that overlap with ALD rather than as a result of damage from alcoholic overload. ..
  42. Arsene D, Farooq O, Bataller R. New therapeutic targets in alcoholic hepatitis. Hepatol Int. 2016;10:538-52 pubmed publisher
    ..steatohepatitis, fibrosis, cirrhosis and its related complications, and the acute-on-chronic state of alcoholic hepatitis. While multidisciplinary efforts continue to be aimed at curbing progression of this spectrum of disorders, ..
  43. Vuittonet C, Halse M, Leggio L, Fricchione S, Brickley M, Haass Koffler C, et al. Pharmacotherapy for alcoholic patients with alcoholic liver disease. Am J Health Syst Pharm. 2014;71:1265-76 pubmed publisher
    ..options for managing ALD, which encompasses a broad spectrum of disorders ranging from steatosis and alcoholic hepatitis to fibrosis, cirrhosis, and hepatocellular cancer...
  44. Gex L, Bernard C, Spahr L. [Child-Pugh, MELD and Maddrey scores]. Rev Med Suisse. 2010;6:1803-4, 1806-8 pubmed
    ..The Maddrey score allows identifying the severe forms of alcoholic hepatitis, which can benefit from a corticotherapy to reduce the high short-term mortality.
  45. Liangpunsakul S, Puri P, Shah V, Kamath P, Sanyal A, Urban T, et al. Effects of Age, Sex, Body Weight, and Quantity of Alcohol Consumption on Occurrence and Severity of Alcoholic Hepatitis. Clin Gastroenterol Hepatol. 2016;14:1831-1838.e3 pubmed publisher
    Only a minority of heavy drinking individuals develop alcoholic hepatitis (AH), for unclear reasons...
  46. Parlesak A, Schäfer C, Bode C. IgA against gut-derived endotoxins: does it contribute to suppression of hepatic inflammation in alcohol-induced liver disease?. Dig Dis Sci. 2002;47:760-6 pubmed
    Endotoxins of intestinal origin are supposed to play an important role in the development of alcoholic hepatitis in man...
  47. Spahr L, Garcia I, Bresson Hadni S, Rubbia Brandt L, Guler R, Olleros M, et al. Circulating concentrations of interleukin-18, interleukin-18 binding protein, and gamma interferon in patients with alcoholic hepatitis. Liver Int. 2004;24:582-7 pubmed
    b>Alcoholic hepatitis (AH) is associated with dysregulated inflammatory and immune responses...
  48. Casey C, Nanji A, Cederbaum A, Adachi M, Takahashi T. Alcoholic liver disease and apoptosis. Alcohol Clin Exp Res. 2001;25:49S-53S pubmed
    ..Casey; (3) Toxicity of ethanol in HepG2 cells that express CYP2E1, by Arthur I. Cederbaum; (4) Mitochondrial regulation of ethanol-induced hepatocyte apoptosis, by M. Adachi; and (5) Apoptosis in alcoholic hepatitis, by T. Takahashi.
  49. John E, Sedhom R, Dalal I, Sharma R. Posterior reversible encephalopathy syndrome in alcoholic hepatitis: Hepatic encephalopathy a common theme. World J Gastroenterol. 2017;23:373-376 pubmed publisher
    ..This report documents the first reported case of PRES in a patient with severe alcoholic hepatitis with hepatic encephalopathy and delves into a molecular pathophysiology of the syndrome.
  50. Korenaga M, Okuda M, Otani K, Wang T, Li Y, Weinman S. Mitochondrial dysfunction in hepatitis C. J Clin Gastroenterol. 2005;39:S162-6 pubmed
    ..These results suggest that antioxidant approaches may prove beneficial for patients with chronic hepatitis C. ..
  51. Xiong Z, Wu P, Huang Y. [Protective mechanisms of radix salviae miltiorrhizae against chronic alcoholic liver injury in mice]. Zhongguo Zhong Xi Yi Jie He Za Zhi. 2005;25:425-8 pubmed
    ..RSM could prevent liver injury from alcohol by way of influencing TLR-4 signal transcription. ..
  52. Jeong J, Sohn J, Son B, Paik C, Kim S, Han D, et al. [Comparison of model for end-stage liver disease score with discriminant function and child-Turcotte-Pugh scores for predicting short-term mortality in Korean patients with alcoholic hepatitis]. Korean J Gastroenterol. 2007;49:93-9 pubmed
    b>Alcoholic hepatitis is an acute or acute-on-chronic inflammatory syndrome associated with significant morbidity and mortality...
  53. Pares A, Deulofeu R, Cisneros L, Escorsell A, Salmeron J, Caballeria J, et al. Albumin dialysis improves hepatic encephalopathy and decreases circulating phenolic aromatic amino acids in patients with alcoholic hepatitis and severe liver failure. Crit Care. 2009;13:R8 pubmed publisher
    ..the effects of albumin dialysis on hepatic encephalopathy and circulating levels of amino acids in severe alcoholic hepatitis. The study was carried out in nine patients with severe alcoholic hepatitis and four with primary biliary ..