title: Transjugular liver biopsy in severe alcoholic hepatitis.
abstract: BACKGROUND
  Alcoholic hepatitis and cirrhosis although part of spectrum of alcoholic liver disease can have overlapping features, and differentiating them using clinical, biochemical, and imaging features is not always possible. Standard therapy for each differs, and steroid therapy while beneficial in alcoholic hepatitis may be detrimental in cirrhosis due to high infectious complications. We analyzed our experience with liver biopsy in patients with severe alcoholic hepatitis.
  
  
  METHODS
  Male patients in the age group of 25-65 years who were clinically diagnosed with severe alcoholic hepatitis (DF > 32) were retrospectively analyzed and included in this study. All of them had undergone transjugular liver biopsy within the first 7 days of hospitalization.
  
  
  RESULTS
  Thirty patients were included. Most were in the 35-55 age group. Jaundice was present in all patients with fever and tender hepatomegaly also being common. On histopathological evaluation, 33.3% (n = 10) suspected clinically to have alcoholic hepatitis had underlying cirrhosis.
  
  
  CONCLUSIONS
  Cirrhosis is found in one third of patients with severe alcoholic hepatitis. This may alter our approach to management of this condition.
authors.affiliation: Department of Gastroenterology and Hepatology, Kasturba Medical College, Manipal University, Manipal, 576 104, India. drshiran@gmail.com.|Department of Gastrenterology, PSG Institute of Medical Sciences and Research, Coimbatore, 641 004, India. drshiran@gmail.com.
authors.forename: Shiran
authors.initials: S
authors.lastname: Shetty
authors.affiliation: Department of Gastrenterology, PSG Institute of Medical Sciences and Research, Coimbatore, 641 004, India.
authors.forename: L
authors.initials: L
authors.lastname: Venkatakrishnan
authors.affiliation: Department of Gastrenterology, PSG Institute of Medical Sciences and Research, Coimbatore, 641 004, India.
authors.forename: J
authors.initials: J
authors.lastname: Krishanveni
authors.affiliation: Department of Pathology, PSG Institute of Medical Sciences and Research, Coimbatore, 641 004, India.
authors.forename: Shantha
authors.initials: S
authors.lastname: Kumari
mesh_terms: D000328:Adult; D000368:Aged; D001706:Biopsy / Q000379:methods*; D003937:Diagnosis, Differential; D005334:Fever / Q000209:etiology; D006519:Hepatitis, Alcoholic / Q000150:complications / Q000175:diagnosis* / Q000473:pathology*; D006529:Hepatomegaly / Q000209:etiology; D006801:Humans; D007565:Jaundice / Q000209:etiology; D008099:Liver / Q000473:pathology*; D008104:Liver Cirrhosis, Alcoholic / Q000175:diagnosis* / Q000209:etiology / Q000473:pathology*; D008297:Male; D008875:Middle Aged; D012189:Retrospective Studies; D012720:Severity of Illness Index
keywords: Alcoholic hepatitis; Alcoholic liver disease; Cirrhosis; Transjugular liver biopsy