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Article Dans Une Revue Médecine Intensive Réanimation Année : 2018

Severe acute alcoholic hepatitis

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E. Nguyen-Khac
R. Sarba
  • Fonction : Auteur
T. Yzet
J. Turpin
  • Fonction : Auteur
D. Chatelain
  • Fonction : Auteur
  • PersonId : 1149906
  • IdRef : 080482635
I. Marcq
C. A. Papillon
  • Fonction : Auteur
  • PersonId : 1151768
  • IdRef : 249120038
C. Attencourt
H. Houchi

Résumé

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.

Dates et versions

hal-03577868 , version 1 (16-02-2022)

Identifiants

Citer

E. Nguyen-Khac, V. Dejour, R. Sarba, T. Yzet, J. Turpin, et al.. Severe acute alcoholic hepatitis. Médecine Intensive Réanimation, 2018, 27 (6), pp.510-521. ⟨10.3166/rea-2018-0069⟩. ⟨hal-03577868⟩

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