Alcoholic liver disease natural history, complications and prognosis: Difference between revisions
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(/* 2010 AASLD/ACG Alcoholic Liver Disease Guidelines : Prognostic Factors (DO NOT EDIT){{cite web |url=http://www.aasld.org/practiceguidelines/Documents/Bookmarked%20Practice%20Guidelines/AlcoholicLiverDisease1-2010.pdf |title=www.aasld.org |forma...) |
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{{CMG}} | {{CMG}} | ||
==Overview== | ==Overview== | ||
== | ==Complications== | ||
====Alcoholic hepatitis==== | ====Alcoholic hepatitis==== | ||
* Portal hypertension (ascites, variceal bleeding, hepatorenal syndrome) | * Portal hypertension (ascites, variceal bleeding, hepatorenal syndrome) | ||
Line 12: | Line 11: | ||
* Hepatocellular carcinoma | * Hepatocellular carcinoma | ||
* [[Hepatic encephalopathy]] | * [[Hepatic encephalopathy]] | ||
==Prognosis== | |||
In absence of steroid therapy 1 in every three patient dies. | In absence of steroid therapy, 1 in every three patient dies. | ||
====Poor Prognostic | ====Poor Prognostic Factors==== | ||
* Prolonged [[prothrombin time]] | * Prolonged [[prothrombin time]] | ||
* Serum [[Bilirubin]] >10 mg/dL | * Serum [[Bilirubin]] >10 mg/dL | ||
Line 22: | Line 21: | ||
* Unresponsive to steroid treatment | * Unresponsive to steroid treatment | ||
* Reversal portal flow on doppler USG | * Reversal portal flow on doppler USG | ||
====Prognostic | ====Prognostic Scores==== | ||
* [[MELD score]] for cirrhosis | * [[MELD score]] for cirrhosis | ||
* Glasgow alcoholic hepatitis score (age, white blood cell, blood urea nitrogen, prothrombin time ratio, and bilirubin level) | * Glasgow alcoholic hepatitis score (age, white blood cell, blood urea nitrogen, prothrombin time ratio, and bilirubin level) |
Revision as of 13:42, 28 October 2012
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Editor-In-Chief: C. Michael Gibson, M.S., M.D. [1]
Overview
Complications
Alcoholic hepatitis
- Portal hypertension (ascites, variceal bleeding, hepatorenal syndrome)
- Coagulopathy
- Intractable jaundice
Cirrhosis
- Hepatocellular carcinoma
- Hepatic encephalopathy
Prognosis
In absence of steroid therapy, 1 in every three patient dies.
Poor Prognostic Factors
- Prolonged prothrombin time
- Serum Bilirubin >10 mg/dL
- Hepatic encephalopathy
- Azotemia
- Leukocytosis
- Unresponsive to steroid treatment
- Reversal portal flow on doppler USG
Prognostic Scores
- MELD score for cirrhosis
- Glasgow alcoholic hepatitis score (age, white blood cell, blood urea nitrogen, prothrombin time ratio, and bilirubin level)
- ABIC score - age, serum bilirubin, serum creatinine
2010 AASLD/ACG Alcoholic Liver Disease Guidelines : Prognostic Factors (DO NOT EDIT)[1]
Class I |
1. " Patients presenting with a high clinical suspicion of alcoholic hepatitis should have their risk for poor outcome stratified using the Maddrey Discriminant Function (MDF), as well as other available clinical data. Evaluating a patient's condition over time with serial calculation of the Model for End-Stage Liver Disease (MELD) score is also justified. (Level of evidence: B) " |
References
- ↑ "www.aasld.org" (PDF). Retrieved 2012-10-27.