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Alcoholic Liver Disease (ALD) (2. Alcoholic hepatitis (Symptoms (Anorexia,…
Alcoholic Liver Disease (ALD)
What is it?
The most common liver disease
3 stages
1. Hepatic steatosis
Reversible w cessation of EtOH
Caused by:
Inc in hepatic synthesis of FA
Dec in FA oxidation
Inc mobilisation of FA from adipose tissue
Inc in TGL production
Trapping of TGL in the liver
Fatty infiltration (known as fatty liver)
2. Alcoholic hepatitis
Characterised by:
Modest elevation of transaminase levels
Inc serum bilirubin
Normal or depressed serum albumin
Anemia
Hepatomegaly
Symptoms
Anorexia
Wt loss
Abdo pain
Diarrhoea
N & V
Weakness
Fever
May resolve w cessation of EtOH
HPHE and counselling for alcohol cessation
3. Alcoholic cirrhosis
Prognosis
Depends on abstinence from alcohol and degree of complications
Considered ESLD
Biopsy
Macro-nodular
Both
Micro-nodular cirrhosis
Ascites
Accumulation of fluid, serum protein, electrolytes in abdo cavity
Caused by portal HPT and dec production of albumin
Clinical features vary:
Portal Hypertension
Ascites
Hepatic encephalopathy
GI bleeding
Symptoms of alcoholic hepatitis