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Alcoholic liver disease: Difference between revisions
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'''Alcoholic liver disease''' (ALD) is an umbrella term for liver conditions caused by significant and chronic [[alcohol]] abuse. It initially causes liver [[steatosis]], which progresses to alcoholic hepatitis to [[cirrhosis]] unless alcohol consumption stops. | <section begin="clinical biochemistry" />'''Alcoholic liver disease''' (ALD) is an umbrella term for liver conditions caused by significant and chronic [[alcohol]] abuse. It initially causes liver [[steatosis]], which progresses to alcoholic hepatitis to [[cirrhosis]] unless alcohol consumption stops. | ||
Almost all who abuse alcohol develop liver steatosis, which is reversible, but only a few progress to hepatitis and cirrhosis. [[Hepatitis C]] is often found in chronic alcoholics and leads to acceleration of alcoholic liver disease. | Almost all who abuse alcohol develop liver steatosis, which is reversible, but only a few progress to hepatitis and cirrhosis. [[Hepatitis C]] is often found in chronic alcoholics and leads to acceleration of alcoholic liver disease. | ||
Excessive ethanol consumption causes more than 60% of chronic liver diseases in the Western countries and is the 5th leading cause of death. Alcoholic liver disease is a major cause of [[liver transplantation]]. | Excessive ethanol consumption causes more than 60% of chronic liver diseases in the Western countries and is the 5th leading cause of death. Alcoholic liver disease is a major cause of [[liver transplantation]].<section end="clinical biochemistry" /> | ||
== Etiology == | == Etiology == | ||
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It’s important to keep in mind that alcohol abuse is dangerous to all organ systems, and symptoms of e.g. [[cardiomyopathy]], neuropathy, and encephalopathy may be present. | It’s important to keep in mind that alcohol abuse is dangerous to all organ systems, and symptoms of e.g. [[cardiomyopathy]], neuropathy, and encephalopathy may be present. | ||
<section begin="clinical biochemistry" /> | |||
== Diagnosis and evaluation == | == Diagnosis and evaluation == | ||
For diagnosis of alcoholic liver disease, it’s important to establish the diagnosis of alcohol abuse, in which case heteroanamnesis may be required. The following laboratory alterations are typical: | For diagnosis of alcoholic liver disease, it’s important to establish the diagnosis of alcohol abuse, in which case heteroanamnesis may be required. The following laboratory alterations are typical: | ||
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Serum ethanol levels can be measured, but this only elevated in case of intake in the last hours. [[Phosphatidylethanol]] (PEth), a phospholipid which is only formed after alcohol consumption, is a marker of long-term alcohol intake. Carbohydrate-deficient transferrin (CDT) is another marker of long-term alcohol intake. | Serum ethanol levels can be measured, but this only elevated in case of intake in the last hours. [[Phosphatidylethanol]] (PEth), a phospholipid which is only formed after alcohol consumption, is a marker of long-term alcohol intake. Carbohydrate-deficient transferrin (CDT) is another marker of long-term alcohol intake. | ||
<section end="clinical biochemistry" /> | |||
[[Ultrasound]] shows characteristic findings depending on the stage. However, it cannot determine whether the cause of liver disease is alcoholic: | [[Ultrasound]] shows characteristic findings depending on the stage. However, it cannot determine whether the cause of liver disease is alcoholic: | ||