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Review
. 2023 May 7;29(17):2551-2570.
doi: 10.3748/wjg.v29.i17.2551.

Alcohol-related hepatitis: A review article

Hunza Chaudhry  1 , Aalam Sohal  2 , Humzah Iqbal  3 , Marina Roytman  4
Affiliations
Review

Alcohol-related hepatitis: A review article

Hunza Chaudhry et al. World J Gastroenterol. .

Abstract

Alcohol-related hepatitis (ARH) is a unique type of alcohol-associated liver disease characterized by acute liver inflammation caused by significant alcohol use. It ranges in severity from mild to severe and carries significant morbidity and mortality. The refinement of scoring systems has enhanced prognostication and guidance of clinical decision-making in the treatment of this complex disease. Although treatment focuses on supportive care, steroids have shown benefit in select circumstances. There has been a recent interest in this disease process, as coronavirus disease 2019 pandemic led to substantial rise in cases. Although much is known regarding the pathogenesis, prognosis remains grim due to limited treatment options. This article summarizes the epidemiology, genetics, pathogenesis, diagnosis and treatment of ARH.

Keywords: Alcohol; Clinical trials; Epidemiology; Hepatitis; Prevalence; Treatment.

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Conflict of interest statement

Conflict-of-interest statement: All the authors report no relevant conflicts of interest for this article.

Figures

Figure 1
Figure 1
Risk factors of alcohol-related hepatitis. ARH: Alcohol-related hepatitis.
Figure 2
Figure 2
Pathogenesis of alcohol-related hepatitis. ADH: Alcohol dehydrogenase.
Figure 3
Figure 3
Fishnet diagram showing laboratory abnormalities, commonly seen in patients with alcohol-related hepatitis. BUN: Blood urea nitrogen; WBC: White blood cell; Glu: Glucose; Hgb: Hemoglobin; Hct: Hematocrit; Plt: Platelet; T.Bili: Total bilirubin; D.Bili: Direct bilirubin; AST: Aspartate transaminase; ALT: Alanine transaminase; ALP: Alkaline phosphatase; PT: Prothrombin time; PTT: Partial thromboplastin time; INR: International normalized ratio.
Figure 4
Figure 4
Computerized tomography showing enlarged liver with smooth contour.
Figure 5
Figure 5
Complications and clinical features in patients with alcohol-related hepatitis. SBP: Spontaneous bacterial peritonitis; AKI: Acute kidney injury.
Figure 6
Figure 6
Diagnostic workup for acute kidney injury in patients with alcohol-related hepatitis. MDF: Maddrey’s discriminant function.
Figure 7
Figure 7
Treatment algorithm for alcohol-related hepatitis. AKI: Acute kidney injury.
See this image and copyright information in PMC

References

    1. Moon AM, Curtis B, Mandrekar P, Singal AK, Verna EC, Fix OK. Alcohol-Associated Liver Disease Before and After COVID-19-An Overview and Call for Ongoing Investigation. Hepatol Commun. 2021;5:1616–1621. - PMC - PubMed
    1. Sohal A, Khalid S, Green V, Hagino J, Chaudhry H, Gulati A, Roytman M. Soaring rates of alcohol-related hepatitis in the latter phase of the COVID-19 pandemic: A new normal? JGH Open. 2023;7:148–151. - PMC - PubMed
    1. Gonzalez HC, Zhou Y, Nimri FM, Rupp LB, Trudeau S, Gordon SC. Alcohol-related hepatitis admissions increased 50% in the first months of the COVID-19 pandemic in the USA. Liver Int. 2022;42:762–764. - PubMed
    1. Ali H, Pamarthy R, Bolick NL, Farooq MF. Ten-year trends and prediction model of 30-day inpatient mortality for alcoholic hepatitis in the United States. Ann Gastroenterol. 2022;35:427–433. - PMC - PubMed
    1. Jinjuvadia R, Liangpunsakul S Translational Research and Evolving Alcoholic Hepatitis Treatment Consortium. Trends in Alcoholic Hepatitis-related Hospitalizations, Financial Burden, and Mortality in the United States. J Clin Gastroenterol. 2015;49:506–511. - PMC - PubMed