Document Detail


Recurrent severe alcoholic hepatitis: clinical characteristics and outcomes.
MedLine Citation:
PMID:  23628964     Owner:  NLM     Status:  MEDLINE    
Abstract/OtherAbstract:
BACKGROUND AND AIMS: Despite high recidivism rates in those treated for alcoholism, recurrent episodes of severe alcoholic hepatitis (SAH) have not been described. Our aim was to assess the clinical characteristics and outcomes in recurrent SAH.
PATIENTS AND METHODS: A retrospective review of patient records was carried out. Recurrent SAH was defined as two or more discrete episodes of SAH (discriminant function≥32) coinciding with recidivism in the same patient, with documented improvement/resolution of jaundice during intervening periods of abstinence.
RESULTS: Of 56 patients with recidivism following index presentation with SAH, 10 (17.9%) developed recurrent SAH. We report on 17 episodes in seven patients with complete data. The mean age and duration of alcohol use were 47.9±7.4 and 16.1±5.2 years, respectively. Compared with those without recurrence, the cohort with recurrent SAH were more likely to be women (57.1 vs. 34.8%, P=0.405), had higher alcohol consumption during relapse (16.0±15.3 vs. 11.3±8.1 U/day, P=0.591) and a recidivism pattern of alcohol relapse after initial abstinence rather than continuous alcohol use. Recurrent episodes were more severe compared with the index one (discriminant function 70.4±27.9 vs. 50.5±10.9; MELD score 26.2±3.7 vs. 22.1±1.5, P<0.05), the overall mortality being 57.1%. Treatment responses to corticosteroids were consistent in 66.7% of patients.
CONCLUSION: Approximately 18% of patients, especially women, develop recurrent SAH because of recidivism, with increasing disease severity and mortality approaching 60%. Our data underscore the urgent need to develop strategies to prevent recidivism following index presentation with SAH.
Authors:
Jonathan R Potts; Mark R Howard; Sumita Verma
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Publication Detail:
Type:  Journal Article    
Journal Detail:
Title:  European journal of gastroenterology & hepatology     Volume:  25     ISSN:  1473-5687     ISO Abbreviation:  Eur J Gastroenterol Hepatol     Publication Date:  2013 Jun 
Date Detail:
Created Date:  2013-04-30     Completed Date:  2013-11-22     Revised Date:  2014-02-07    
Medline Journal Info:
Nlm Unique ID:  9000874     Medline TA:  Eur J Gastroenterol Hepatol     Country:  England    
Other Details:
Languages:  eng     Pagination:  659-64     Citation Subset:  IM    
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MeSH Terms
Descriptor/Qualifier:
Adult
Bilirubin / blood
Biological Markers / blood
Biopsy
Ethanol / administration & dosage
Female
Glucocorticoids / therapeutic use
Hepatitis, Alcoholic / drug therapy,  etiology*,  pathology
Humans
Liver / pathology
Male
Middle Aged
Prognosis
Recurrence
Retrospective Studies
Risk Factors
Sex Factors
Temperance
Treatment Outcome
Chemical
Reg. No./Substance:
0/Biological Markers; 0/Glucocorticoids; 3K9958V90M/Ethanol; RFM9X3LJ49/Bilirubin
Comments/Corrections
Erratum In:
Eur J Gastroenterol Hepatol. 2014 Feb;26(2):253

From MEDLINE®/PubMed®, a database of the U.S. National Library of Medicine


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