Epidemiology

Etiology

Pathophysiology

Heavy ethanol consumption �?intrahepatic oxidative damage �?recruitment of neutrophils to the liver

Clinical features

• Acute hepatitis: tender hepatomegaly, acute jaundice, malaise, nausea, anorexia, fatigue, fever, weight loss, tachypnea
• Acute alcohol withdrawal: tremor, agitation, tachycardia, alcohol withdrawal seizures, alcohol withdrawal delirium

Diagnostics

LFTs

• AST: > 50 IU/L
• Both AST and ALT: < 400 IU/L
• AST:ALT ratio: > 1.5
• GGT: > 100 IU/L
• ALP: �?>[!Mnemonic]

AST > ALT in alcoholic hepatitis: Remember “make a toAST with alcohol!�?

Liver biopsy

• Marked intrahepatic neutrophilic infiltration
• Hepatocellular ballooning
• Mallory bodies
• Steatosis

Treatment