Andresen-Streichert H, Beres Y, Weinmann W, et al.Sensitivity and specificity of urinary ethyl glucuronide and ethyl sulfate in liver disease patients. Stewart SH, Koch DG, Burgess DM, et al.Primary care validation of a single screening question for drinkers. Seale JP, Boltri JM, Shellenberger S, et al.AUDIT-C as a brief screen for alcohol misuse in primary care. Bradley KA, DeBenedetti AF, Volk RJ, et al.Interaction between alcohol consumption and metabolic syndrome in predicting severe liver disease in the general population. Ã…berg F, Helenius-Hietala J, Puukka P, et al.Diagnosis and treatment of alcohol-associated liver disease: a review. Diagnosis, evaluation, and management of ascites, spontaneous bacterial peritonitis and hepatorenal syndrome: 2021 practice guidance by the American Association for the Study of Liver Diseases. Biggins SW, Angeli P, Garcia-Tsao G, et al.Diagnosis of alcohol-associated hepatitis: when is liver biopsy required?. Main drivers of outcome differ between short term and long term in severe alcoholic hepatitis: a prospective study. Louvet A, Labreuche J, Artru F, et al.The knowns and unknowns of treatment for alcoholic hepatitis. Standard definitions and common data elements for clinical trials in patients with alcoholic hepatitis: recommendation from the NIAAA Alcoholic Hepatitis Consortia. Crabb DW, Bataller R, Chalasani NP, et al.Prednisolone or pentoxifylline for alcoholic hepatitis. Thursz MR, Richardson P, Allison M, et al.Genetic and environmental susceptibility to alcoholic hepatitis. Current trends in liver transplantation for alcoholic hepatitis. Diagnosis and treatment of alcohol-associated liver diseases: 2019 practice guidance from the American Association for the Study of Liver Diseases. The presence of underlying cirrhosis and continued alcohol use negatively impact long-term prognosis. Pharmacologic treatment of alcohol use disorder can aid patients in maintaining abstinence from alcohol. Long-term follow-up should focus on abstinence from alcohol, management of underlying cirrhosis, and evaluation for liver transplantation if indicated. Hospital physicians should involve a multidisciplinary team, including substance abuse specialists, gastroenterologists or hepatologists, nephrologists, dietitians, and intensivists, as appropriate. Responsiveness to corticosteroid therapy should be evaluated using the Lille score on day 7 of treatment. Corticosteroids are recommended for severe alcoholic hepatitis. Treatment for moderate disease primarily consists of supportive care, including alcohol cessation and nutritional support. Laboratory-based prognostic scores, including Maddrey Discriminant Function and the Model for End-Stage Liver Disease, help determine disease severity and treatment options. Close monitoring for inflammation and organ failure is crucial throughout hospitalization. Initial workup should include chest radiography and cultures of peritoneal fluid, blood, and urine. Diagnosis of alcoholic hepatitis is primarily clinical, based on a consensus definition from the National Institute on Alcohol Abuse and Alcoholism. High rates of concomitant infections, systemic inflammation, and multiorgan failure lead to significant morbidity and mortality. Alcoholic hepatitis is a clinical syndrome characterized by acute-onset jaundice and liver enzyme abnormalities in the setting of long-term heavy alcohol use.
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