Severe acute alcoholic hepatitis

E. Nguyen-Khac (1, 2) , V. Dejour (3) , R. Sarba , T. Yzet (1) , J. Turpin , D. Chatelain (1, 4) , I. Marcq , C. Chivot (5) , Julien Maizel (1, 6) , C. A. Papillon , C. Attencourt (4) , H. Houchi

1 CHU Amiens-Picardie
2 GRAP - Groupe de Recherche sur l'alcool et les pharmacodépendances - UMR INSERM_S 1247
3 Polyclinique Saint-Claude
4 CHIMERE - CHirurgie, IMagerie et REgénération tissulaire de l’extrémité céphalique - Caractérisation morphologique et fonctionnelle - UR UPJV 7516
5 Département de chirurgie maxillofaciale et stomatologie [CHU d'Amiens-Picardie]
6 MP3CV - Mécanismes physiopathologiques et conséquences des calcifications vasculaires - UR UPJV 7517

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.

Domaines: Sciences du Vivant [q-bio]

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⟩