Hépatite alcoolique
Résumé
Alcoholic hepatitis. In a context of chronic alcoholic intoxication, the diagnosis of alcoholic hepatitis (AH) relies on a histological definition. When it is symptomatic, AH is a clinical syndrome associating jaundice, moderate fever, sensitivity of the right upper quadrant, loss of appetite and signs of hepatocellular insufficiency in severe forms. Typical biological tests show a moderate cytolysis with predominant AST, a high level of ãGT, and leukocytosis on neutrophils. Rising level of bilirubin and INR rates and low TP ratio are markers of severity of the disease. Regardless, the initial severity, abstinence has a decisive influence on long-term survival. In severe forms (Maddrey ≥ 32), corticosteroid for one month improves short-term survival, which response is evaluated by the Lille score. Accelerated procedure liver transplantation may be offered to some non-responders to medical treatment.