Hépatite alcoolique aiguë sévère

Eric Nguyen-Khac (1, 2) , Valérie Dejour (3) , Ruxandra Sarba (3) , Thierry Yzet (4) , Denis Chatelain (5) , Ingrid Marcq (2) , Cyril Chivot (4) , Charles Antoine Papillon , Christophe Attencourt (4, 5) , Hakim Houchi (2)

1 Service d'Hépato Gastroenterologie [CHU Amiens-Picardie]
2 GRAP - Groupe de Recherche sur l'alcool et les pharmacodépendances - UMR INSERM_S 1247
3 UPJV - Université de Picardie Jules Verne
4 CHU Amiens-Picardie
5 CHIMERE - CHirurgie, IMagerie et REgénération tissulaire de l’extrémité céphalique - Caractérisation morphologique et fonctionnelle - UR UPJV 7516

All chronic and excessive consumer of alcohol with recent jaundice should be assessed using a Maddrey's score for severe acute alcoholic hepatitis. Corticosteroids are the first line of 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 month. Early liver transplantation in a selected group of patients with non-response to corticosteroids significantly improves 6th month and long-term survival. © 2018 Elsevier Masson SAS

Domaines: Histoire

Eric Nguyen-Khac, Valérie Dejour, Ruxandra Sarba, Thierry Yzet, Denis Chatelain, et al.. Hépatite alcoolique aiguë sévère. La Presse Médicale, 2018, 47 (7-8), pp.655-666. ⟨10.1016/j.lpm.2018.05.013⟩. ⟨hal-03690901⟩