Alcoholic liver disease Flashcards
What is alcoholic liver disease?
An umbrella term for disorders of the liver that are caused by drinking too much alcohol
What diseases come under the term ‘alcoholic liver disease’?
Fatty liver disease
Alcoholic hepatitis
Chronic hepatitis
Cirrhosis
What are the risk factors for developing alcoholic liver disease?
Drinking a lot of alcohol
Drinking alcohol outside meal times
Being female: women are twice as susceptible
Hepatitis C: accelerates progress of liver injury
Genetic factors: some people are more susceptible than others
Diet: malnutrition, lack of vitamin A + E can mean hepatocytes are less able to regenerate
How long does it take for fatty liver disease to start developing?
Fatty liver can begin to develop even after a few weeks of heavy drinking
Is the damage caused by fatty liver reversible?
Yes, if you stopped drinking
Otherwise it will progress to fibrosis and cirrhosis
What is steatosis?
Another name for fatty liver disease
The accumulation of fatty acids in the liver cells
What is fatty liver disease?
When fatty acids accumulate in the liver cells
What is the histological appearance of fatty liver disease?
Globules of triglycerides in the hepatocyte cytoplasms
Pathogenesis of fatty liver disease?
Ethanol –> acetaldehyde
Aldehyde is then involved in a chain reaction resulting in the increased production of fatty acids
They bind to glycerol forming trigylcerides
They accumulate in the cells
What is alcoholic hepatitis?
Inflammation of the hepatocytes caused by alcohol
What is the histological appearance of alcoholic hepatitis
Steatosis
Swollen, foamy hepatocytes
Mallory bodies
Neutrophils
Fibrosis
What are Mallory bodies?
Amorphous eosinophilic material
Which cytokines are involved in alcoholic hepatitis?
Pro-inflammatory
TNF-a
IL6
IL8
What clinical features are seen in alcoholic hepatitis?
Rapid onset jaundice Nausea Right upper quadrant pain Fever Ascites Encephalopathy
Management of alcoholic hepatitis?
Supportive treatment
Nutritional management
Stop drinking alcohol
Corticosteroids reduce inflammation
Prevention of worsening
