Severe acute alcoholic hepatitis

Abstract : All the chronic and excessive consumers of alcohol with recent jaundice should be assessed using a Maddrey's score for severe acute alcoholic hepatitis. Corticosteroids are the first-line 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 months. Early liver transplantation in a selected group of patients with non-response to corticosteroids significantly improves at sixth-month and is long-term survival.