Syracuse

Severe acute alcoholic hepatitis

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Nguyen-Khac, E. | Dejour, V. | Sarba, R. | Yzet, T. | Turpin, J. | Chatelain, D. | Marcq, I. | Chivot, C. | Maizel, Julien | Papillon, C. A. | Attencourt, C. | Houchi, H.

Edité par CCSD ; Société de Réanimation de langue française -

International audience. All the chronic and excessive consumers of alcohol with recent jaundice should be assessed using a Maddrey's score for severe acute alcoholic hepatitis. Corticosteroids are the first-line treatment associated with an appropriate nutritional support and alcohol abstinence. Corticosteroids plus N-acetylcysteine combination improves short-term survival over corticosteroids alone, and could be proposed as a first-line therapy. The response to treatment is evaluated at the 7th day of treatment, with the Lille model <= 0.45. Prognostic of non-responders to corticosteroids with Lille model > 0.45 is dramatically low with 23% survival at 6 months. Early liver transplantation in a selected group of patients with non-response to corticosteroids significantly improves at sixth-month and is long-term survival.

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