Background: Alcoholic hepatitis (AH) is an inflammatory disorder of the liver characterized clinically by jaundice, hepatomegaly, and abdominal pain, and histologically by macrovesicular steatosis and necroinflammation.
Methods: This clinical review will cover what is known about the pathogenesis, clinical presentation, current treatments, and novel therapies for AH.
Results: The pathogenesis and treatment of AH remain areas of active research. Although abstinence is the cornerstone of therapy for all stages of alcoholic liver disease, corticosteroids have shown modest short-term benefits in treatment of severe AH.
Conclusions: Improved understanding of the pathogenesis of AH has expanded the range of potential treatments for this devastating disease. Several novel therapies are also currently in various stages of testing through clinical trials.
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http://dx.doi.org/10.1111/acer.12956 | DOI Listing |
Rev Esp Enferm Dig
January 2025
Digestive Diseases, Hospital Universitario Virgen de las Nieves, España.
Cholesterol ester storage disease (CESD) is a rare autosomal recessive lysosomal storage disorder caused by mutations in the LIPA gene, leading to reduced lysosomal acid lipase activity, cholesterol ester accumulation, and systemic manifestations including liver dysfunction and dyslipidemia. We report the case of a 25-year-old male presenting with subacute jaundice, hyperbilirubinemia (total bilirubin 51 mg/dL, predominantly direct), and dyslipidemia characterized by elevated total cholesterol and low HDL cholesterol levels. Initial diagnostic workup for acute hepatitis and liver dysfunction, including serological and imaging studies, was unremarkable.
View Article and Find Full Text PDFAlcohol Alcohol
January 2025
Subdivision of Gastroenterology and Hepatology, 5th Department of Internal Medicine, Comenius University Faculty of Medicine, University Hospital Bratislava, Ružinovská 6, 826 06, Bratislava, Slovakia.
Background And Aims: Alcohol-associated hepatitis (AH) frequently triggers acute decompensation (AD) in cirrhosis, with severe AH linked to high short-term mortality, especially in acute-on-chronic liver failure. Current corticosteroid treatments have limited efficacy, highlighting the need for new therapies. We hypothesized that severe AH outcomes are influenced by early specialized care; thus, we examined the impact of time-to-tertiary care (TTTc).
View Article and Find Full Text PDFZhejiang Da Xue Xue Bao Yi Xue Ban
January 2025
Department of Family Medicine, Run Run Shaw Hospital, Zhejiang University School of Medicine, Hangzhou 310016, China.
Inflammatory senescence is a process of cellular dysfunction associated with chronic inflammation, which plays a significant role in the onset and progression of liver diseases,and the research on its mechanisms becomes a hotspot currently. In viral hepatitis, the mechanisms of inflammatory senescence primarily involve oxidative stress, cell apoptosis and necrosis, as well as gut microbiota dysbiosis. In non-alcoholic fatty liver disease, the mechanisms of inflammatory senescence are more complex, involving insulin resistance, fat deposition, lipid metabolism disorders, gut microbiota dysbiosis, and NAD metabolism abnormalities.
View Article and Find Full Text PDFJ Clin Pathol
January 2025
Institute of Liver Studies, King's College Hospital, London, UK
Aims: To reveal clinicopathological characteristics of alcoholic foamy degeneration (AFD)-an uncommon form of alcoholic liver injury.
Methods: Clinicopathological features of AFD (n=9) were examined in comparison to those of severe alcoholic hepatitis (SAH; n=12).
Results: Patients with AFD presented with either biochemical liver dysfunction (n=1) or clinical jaundice (n=8).
Am Fam Physician
January 2025
University of Florida College of Medicine, Gainesville.
Jaundice is an indication of hyperbilirubinemia and is caused by derangements in bilirubin metabolism. It is typically apparent when serum bilirubin levels exceed 3 mg/dL and can indicate serious underlying disease of the liver or biliary tract. A comprehensive medical history, review of systems, and physical examination are essential for differentiating potential causes such as alcoholic liver disease, biliary strictures, choledocholithiasis, drug-induced liver injury, hemolysis, or hepatitis.
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