title: Acute alcoholic hepatitis.
abstract: Acute alcoholic hepatitis (AAH) is a frequent inflammatory liver disease with high short-term mortality rate. In this review, relationships between alcohol abuse and the epidemiology and the outcomes of AAH are discussed, as well as AAH pathogenesis. The role of endotoxins, tumor necrosis factor alpha, fibroblasts, and immune response to altered hepatocyte proteins is discussed. The need of a careful prognosis, supported by the use of Maddrey score, by the model for end-stage liver disease [Mayo end-stage liver disease (MELD)] score or by the Glasgow alcoholic hepatitis score, is outlined, as the use of the most effective drugs (glucocorticoids and anti-tumor necrosis factor alpha infliximab) is recommended only in severe AAH cases. The problems of liver transplant in severe AAH, and the need of a 6-month alcohol abstinence before transplant, are discussed, as well as the need of a careful psychologic assessment before the transplant.
authors.affiliation: Alcohol Liver Disease Unit, University "La Sapienza", Roma, Italy. mauro.ceccanti@uniroma1.it
authors.forename: Mauro
authors.initials: M
authors.lastname: Ceccanti
authors.forename: Adolfo
authors.initials: A
authors.lastname: Attili
authors.forename: Giuseppe
authors.initials: G
authors.lastname: Balducci
authors.forename: Fabio
authors.initials: F
authors.lastname: Attilia
authors.forename: Stefano
authors.initials: S
authors.lastname: Giacomelli
authors.forename: Claudia
authors.initials: C
authors.lastname: Rotondo
authors.forename: Guido Francesco
authors.initials: GF
authors.lastname: Sasso
authors.forename: Elias
authors.initials: E
authors.lastname: Xirouchakis
authors.forename: Maria Luisa
authors.initials: ML
authors.lastname: Attilia
mesh_terms: D000208:Acute Disease; D000818:Animals; D000431:Ethanol / Q000378:metabolism; D006519:Hepatitis, Alcoholic / Q000175:diagnosis / Q000473:pathology / Q000503:physiopathology / Q000628:therapy; D022781:Hepatocytes / Q000737:chemistry; D006530:Hepatorenal Syndrome / Q000209:etiology; D006801:Humans; D008070:Lipopolysaccharides; D016031:Liver Transplantation; D011379:Prognosis; D014409:Tumor Necrosis Factor-alpha / Q000502:physiology
chemical_list: D008070:Lipopolysaccharides; D014409:Tumor Necrosis Factor-alpha; D000431:Ethanol