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copy;2010 Baishideng Publishing Group Co.
World J Gastroenterol. Oct 21, 2010; 16(39): 4905-4912
Published online Oct 21, 2010. doi: 10.3748/wjg.v16.i39.4905
Published online Oct 21, 2010. doi: 10.3748/wjg.v16.i39.4905
Table 1 Questions to ask patients with suspected alcoholic hepatitis
When did you first start to drink alcohol? |
How many days per week do you usually drink? |
How many years have you been drinking on a regular or daily basis? |
How many times have you been arrested for driving under the influence of alcohol? |
How many times have you been arrested for public intoxication? |
What type of alcohol do you usually drink? Beer? Wine? Hard liquor? |
How many drinks of each type of alcohol do you drink on an average day? |
Do you usually drink at home? Bars? |
Have you been through an alcohol rehabilitation program? What type-inpatient or outpatient? How many times? |
Have there been prolonged times when you drank no alcohol? |
When was your last drink? |
Table 2 Symptoms and signs of alcoholic hepatitis
% | |
Common Presenting Symptoms of Alcoholic Hepatitis[10-13] | |
Anorexia | 27-77 |
Nausea and vomiting | 34-55 |
Abdominal pain | 27-46 |
Weight loss | 29-43 |
Physical Examination Findings | |
Hepatomegaly | 71-81 |
Ascites | 35 |
Encephalopathy (from asterixis to coma) | 18-23 |
Gastrointestinal bleeding requiring transfusion | 23 |
Jaundice | 37-100 |
Malnutrition | 56-90 |
Hepatic bruit | 59 |
Table 3 International ascites club criteria for hepatorenal syndrome[37]
Cirrhosis with ascites |
Serum creatinine > 1.5 mg/dL (> 133 μmol/L) |
No improvement in serum creatinine (< 1.5 mg/dL) after at least 2 d with diuretic withdrawal, and volume expansion with intravenous albumin. The recommended dose is 1 g/kg of body weight per day up to a maximum of 100 g/d |
Absence of shock |
No current or recent treatment with nephrotoxic drugs |
Absence of parenchymal kidney disease as indicated by proteinuria > 500 mg/d, microhematuria (> 50 red blood cells per high power field) and/or abnormal renal ultrasonography |
Table 4 Use of oxandrolone for alcoholic hepatitis
Dose | Oxandrolone 40 mg orally daily |
Duration of therapy | 30 d maximum |
Circumstances for use | Maddrey score ≥ 80 on admission |
No improvement in Maddrey score or MELD after 10-14 d of pentoxifylline |
- Citation: Amini M, Runyon BA. Alcoholic hepatitis 2010: A clinician’s guide to diagnosis and therapy. World J Gastroenterol 2010; 16(39): 4905-4912
- URL: https://www.wjgnet.com/1007-9327/full/v16/i39/4905.htm
- DOI: https://dx.doi.org/10.3748/wjg.v16.i39.4905