Alcohol-related liver disease (ARLD) refers to the spectrum of hepatic pathology arising from excessive alcohol consumption. In contrast to most of continental Europe, where the incidence is falling, ARLD is a growing clinical problem in the UK and currently accounts for ten percent of all deaths occurring between 40 - 49 years of age. Severe alcoholic hepatitis (AH) is arguably the most florid manifestation of ARLD, presenting with jaundice and features of hepatic decompensation, often in those without an existing diagnosis of liver disease. Despite abstinence short-term mortality approaches 40%, which may be improved by early diagnosis and timely medical therapy. Among current controversies in the management of severe AH are the necessity for liver biopsy to confirm the diagnosis, and hence there is a recognised need for non-invasive diagnostic aids. Corticosteroids have remained the mainstay of therapy for over 30 years, although a significant minority fail to respond and are particularly susceptible to infections as a consequence of treatment. A means of prospectively and non-invasively identifying these individuals would be a significant advancement.
|Date of Award
|1 Jan 2014