Alcoholic liver disease - new perspectives. (CROSBI ID 88986)
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Duvnjak, M ; Virović, L ; Pavić, T ; Ostojić, R
engleski
Alcoholic liver disease - new perspectives.
Alcoholic liver disease is an important cause of illness and death around the world. Excessive alcohol consumption can induce a spectrum of abnormalities in the liver, associated with a range of clinical syndromes. The three distinctive patterns of liver injury are fatty liver, alcoholic hepatitis and cirrhosis. Each one of these may be the sole manifestation of alcoholic liver disease or may coexist with one or both of the others. Fatty liver (steatosis) is the most common and innocuous of the three ; it is often completely asymptomatic and is fully reversible. Alcoholic hepatitis is associated with inflammation and liver cell necrosis, and produces symptoms that often resemble viral or toxin-induced hepatitis. It can be reversible, especially if the initial injury is mild and furher exposure to alcohol is avoided ; however if repeated, leads to fibrosis and consequent cirrhosis. Alcoholic cirrhosis is the end-stage of the alcoholic liver disease. It is the most common form of cirrhosis, and among the top ten causes of death in the western world. It occurs in approximately 10-20% of alcoholics, represents a final and irreversible stage of alcoholic liver disease associated with a spectrum of clinical findings that result mostly from portal vein hypertension and hepatic failure. Treatment options are limited ; complete abstinence from alcohol is of crucial importance. Adequate nutrition, symptomatic therapy, and corticosteroids in chosen cases of severe hepatitis and encephalopathy, are the only therapeutic options currently available, with liver transplantation being the only method that offers significant opportunities to the patient. New treatment options are being tested and results are still expected. Prognosis of alcoholic cirrhosis is generally poor, but depends largely on present complications and patient's abstinence. Five-year survival rate ranges from 30-40% for those who continue to drink, to 60-70% for those who abstain from alcohol.
alcoholic liver disease; etiology; pathogenesis; diagnosis; treatment
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