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Natural history of alcoholic hepatitis

I. The acute disease

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Abstract

One hundred and sixty-nine patients with alcoholic hepatitis were identified on the basis of a blind review of 1260 consecutive liver biopsies. All of these patients consumed large amounts of alcoholic beverages. Drunkenness was common, although alcoholic hepatitis occurred without recurrent overt inebriation. The duration of excessive drinking ranged from 3 months to 36 years. In 7.7% of patients, excessive drinking was of less than 1 year's duration. The most common complaints were anorexia in 77%, nausea and vomiting in 55%, abdominal pain in 46% and weight loss in 43%. On admission, 81% had hepatomegaly, 55% were malnourished, 37% were jaundiced, 35% had ascites, 22% had gastrointestinal bleeding, 56% had fever, but in half of these, the fever was explained by reasons other than alcoholic hepatitis. In 43%, the hematocrit was less than 30%, and leucocytosis was seen in 34%. Three-fourths of the livers had significant steatosis, and 27.2% had septa or cirrhosis. The clinical course of 15% of patients deteriorated soon after hospitalization, but after several weeks of increasing illness, they improved. For the 169 patients, the mortality rate was 4%.

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Author information

Authors and Affiliations

  1. From the Grady Memorial Hospital, USA

    Mark W. Lischner MD, James F. Alexander MD & John T. Galambos MD

  2. the Department of Medicine, Emory University School of Medicine, Atlanta, Ga

    Mark W. Lischner MD, James F. Alexander MD & John T. Galambos MD

Authors
  1. Mark W. Lischner MD
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  2. James F. Alexander MD
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  3. John T. Galambos MD
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Additional information

Supported in part by USPHS Grant TI AM05151.

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Lischner, M.W., Alexander, J.F. & Galambos, J.T. Natural history of alcoholic hepatitis. Digest Dis Sci 16, 481–494 (1971). https://doi.org/10.1007/BF02235538

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