GASTROENTEROLOGY ARTICLE OF THE WEEK
February 28, 2002
Menon KV, Gores GJ, Shah VH. Pathogenesis, diagnosis and treatment of alcoholic liver disease. Mayo Clin Proc 2001;76:1021-1029.
1. Corticosteroids for the treatment of alcoholic hepatitis should not be used in patients with
a. GI bleeding
b. encephalopathy
c. mild alcoholic hepatitis
d. jaundice
e. sepsis
d. renal failure
2. Carbohydrate-deficient transferrin
a. is a measure of liver damage due to alcohol
b. remains elevated for weeks after heavy alcohol use
c. develops independently of liver injury
d. is specific for alcohol use, but not very sensitive
True or False
3. Only about 15% to 20% of alcohol abusers develop alcoholic hepatitis and/or cirrhosis.
4. Dietary protein should be restricted to 30g/day in patients with acute alcoholic hepatitis.
5. Acute alcoholic hepatitis may mimic biliary tract disease, the presence of hepatomegaly suggests alcoholic hepatitis rather than biliary disease.
6. Once alcoholic cirrhosis develops, alcoholic hepatitis and hepatomegaly rarely occurs.
7. Corticosteroid treatment for alcoholic hepatitis is unlikely to help patients without hepatic encephalopathy
8. TNF-alfa levels are increased in alcoholic liver disease and levels may correlate with severity of disease.
9. Colchicine is not effective in the treatment of alcoholic hepatitis
10. Post-transplantation, only abut 15% to 30% of alcoholic patients relapse (drink excessively again).