title: Alcoholic Hepatitis.
abstract: Alcoholic hepatitis (AH) is a common disease associated with significant morbidity and mortality. Most often the diagnosis is suggested by a history of heavy alcohol excess in a patient with features of hepatic decompensation. In its purest form, AH is a histologic diagnosis of acute hepatic inflammation in response to alcohol. The primary objective of treatment for AH is to support long-term alcohol abstinence and to achieve adequate nutrition with lifestyle modification; goal setting and education are integral to long-term medical management. Severity at presentation (calculated by way of the Maddrey score) determines outcome. Patients with AH represent a heterogeneous group with regard to severity and pathogenesis, with various therapeutic interventions assessed in patients with severe AH. To date, corticosteroids have been studied most, and despite remaining controversial, warrant a place in the treatment of selected patients. Recent advances in unraveling the aspects of disease pathogenesis in AH have raised the possibility of targeted therapies, such as anti-tumor necrosis factor-a monoclonals and pentoxifylline. Orthotopic liver transplantation is not recommended for patients with severe acute AH, as most have an unclear long-term prognosis in the context of ongoing excess alcohol ingestion at presentation.
authors.affiliation: Department of Medicine, Mount Sinai Medical Center, One Gustave Levy Place, New York, NY 10029-6574, USA.
authors.forename: Kaushik
authors.initials: K
authors.lastname: Agarwal
authors.forename: Nickolas
authors.initials: N
authors.lastname: Kontorinis
authors.forename: Nickolas
authors.initials: N
authors.lastname: Kontorinis
authors.forename: Douglas T
authors.initials: DT
authors.lastname: Dieterich
authors.forename: Douglas T
authors.initials: DT
authors.lastname: Dieterich