[Severe acute alcoholic hepatitis]

Eric Nguyen-Khac, Valérie Dejour, Ruxandra Sarba, Thierry Yzet, Denis Chatelain, Ingrid Marcq, Cyril Chivot, Charles Antoine Papillon, Christophe Attencourt, Hakim Houchi
La Presse Médicale 2018, 47 (7-8 Pt 1): 655-666
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.

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