RICHARD A. HELMAN, M.D.; MICHAEL H. TEMKO, M.D.; SYLVANUS W. NYE, M.D.; HAROLD J. FALLON, M.D.
Thirty-seven patients with acute alcoholic hepatitis documented by liver biopsy were studied on a research unit during the healing phase. The clinical picture varied from hepatic coma to an asymptomatic condition. Serum glutamic-oxalacetic transaminase was abnormal in all patients, but the most severely ill had significantly lower albumin levels and more prolonged prothrombin times. Patients were randomly given prednisolone or placebo for 4 weeks, and liver biopsy was repeated at 4 weeks and 4 months. Seven of 15 patients with hepatic encephalopathy died, including all 6 on placebo and 1 of 9 given prednisolone. Prednisolone improved caloric intake in the severe and moderately ill patients. Five of 9 patients with no cirrhosis on first biopsy developed cirrhosis during the 4-month follow-up. Histologic improvement was slow, and prednisolone did not affect the rate of improvement or prevent cirrhosis.
HELMAN RA, TEMKO MH, NYE SW, FALLON HJ. Alcoholic Hepatitis: Natural History and Evaluation of Prednisolone Therapy. Ann Intern Med. ;74:311–321. doi: 10.7326/0003-4819-74-3-311
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Published: Ann Intern Med. 1971;74(3):311-321.
Gastroenterology/Hepatology, Liver Disease, Tobacco, Alcohol, and Other Substance Abuse.
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Print ISSN: 0003-4819 | Online ISSN: 1539-3704
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