Bilirubin response to corticosteroids in severe alcoholic hepatitis.
Eur J Gastroenterol Hepatol
; 17(7): 759-62, 2005 Jul.
Article
em En
| MEDLINE
| ID: mdl-15947554
ABSTRACT
INTRODUCTION:
There is little consensus on the management of alcoholic hepatitis, particularly with regard to corticosteroid therapy. We aimed to identify those patients who respond to corticosteroid therapy for alcoholic hepatitis.METHODS:
We identified 37 patients with alcoholic hepatitis with a modified Maddrey's discriminant function of 32 or greater. We assessed their outcomes at 28 and 56 days treatment after admission relative to their response to corticosteroid treatment.RESULTS:
Corticosteroid treated patients experienced a change in the serum bilirubin concentration after 6-9 days of -23.0+/-4.7%. Overall, the mortality was 18.9 and 35.1% at 28 and 56 days. Response to corticosteroids was defined as a 25% fall in serum bilirubin after 6-9 days of treatment. The mortality of the non-responders was 36.8% and 57.9% at 28 and 56 days compared with 0% (P=0.0148) and 11.1% (P=0.0084) for corticosteroid responders.CONCLUSIONS:
Patients with a 25% fall in bilirubin after 6-9 days of corticosteroid therapy have a significant and sustained improvement in outcome.
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Coleções:
01-internacional
Base de dados:
MEDLINE
Assunto principal:
Bilirrubina
/
Prednisolona
/
Glucocorticoides
/
Hepatite Alcoólica
Tipo de estudo:
Observational_studies
/
Risk_factors_studies
Limite:
Humans
/
Middle aged
Idioma:
En
Ano de publicação:
2005
Tipo de documento:
Article