The Mexican consensus on alcoholic hepatitis
Alcoholic hepatitis is a frequent condition in the Mexican population. It is characterized by acute-on-chronic liver failure, important systemic inflammatory response, and multiple organ failure. The severe variant of the disease implies elevated mortality. Therefore, the Asociación Mexicana de G...
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| Format: | Article |
| Language: | English |
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2020
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| Online Access: | http://eprints.uanl.mx/20052/1/1-s2.0-S2255534X20300542-main.pdf |
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| author | Velarde Ruiz Velasco, José Antonio Higuera de la Tijera, María de Fátima Castro Narro, Graciela Zamarripa Dorsey, F. Abdo Francis, J.M. Haddad, I. Aiza Aldana Ledesma, Juan Manuel Bielsa Fernández, María Victoria Cerda Reyes, Eira Cisneros Garza, Laura Esthela Contreras Omaña, Raul Reyes Dorantes, A. Fernández Pérez, Nicolas Joaquín García Jiménez, Edgar Santino Icaza Chávez, M. E. Kershenobich Stalnikowitz, David Lira Pedrín, M.A. Moreno Alcántar, Rosalba Pérez Hernández, J. L. Ramos Gómez, Mayra Virginia Rizo Robles, M.T. Solana Sentíes, S. Torre Delgadillo, Adriana |
| author_facet | Velarde Ruiz Velasco, José Antonio Higuera de la Tijera, María de Fátima Castro Narro, Graciela Zamarripa Dorsey, F. Abdo Francis, J.M. Haddad, I. Aiza Aldana Ledesma, Juan Manuel Bielsa Fernández, María Victoria Cerda Reyes, Eira Cisneros Garza, Laura Esthela Contreras Omaña, Raul Reyes Dorantes, A. Fernández Pérez, Nicolas Joaquín García Jiménez, Edgar Santino Icaza Chávez, M. E. Kershenobich Stalnikowitz, David Lira Pedrín, M.A. Moreno Alcántar, Rosalba Pérez Hernández, J. L. Ramos Gómez, Mayra Virginia Rizo Robles, M.T. Solana Sentíes, S. Torre Delgadillo, Adriana |
| author_sort | Velarde Ruiz Velasco, José Antonio |
| collection | Repositorio Institucional |
| description | Alcoholic hepatitis is a frequent condition in the Mexican population. It is characterized
by acute-on-chronic liver failure, important systemic inflammatory response, and
multiple organ failure. The severe variant of the disease implies elevated mortality. Therefore,
the Asociación Mexicana de Gastroenterología and the Asociación Mexicana de Hepatología
brought together a multidisciplinary team of health professionals to formulate the first Mexican consensus on alcoholic hepatitis, carried out utilizing the Delphi method and resultingin 37 recommendations. Alcohol-related liver disease covers a broad spectrum of patholo-gies that includes steatosis, steatohepatitis, different grades of fibrosis, and cirrhosis and itscomplications. Severe alcoholic hepatitis is defined by a modified Maddrey’s discriminant func-tion score ≥ 32 or by a Model for End-Stage Liver Disease (MELD) score equal to or above 21.There is currently no specific biomarker for its diagnosis. Leukocytosis with neutrophilia, hyper-bilirubinemia (>3 mg/dl), AST > 50 U/l (< 400 U/l), and an AST/ALT ratio > 1.5-2 can guide thediagnosis. Abstinence from alcohol, together with nutritional support, is the cornerstone oftreatment. Steroids are indicated for severe disease and have been effective in reducing the28-day mortality rate. At present, liver transplantation is the only life-saving option for patientsthat are nonresponders to steroids. Certain drugs, such as N-acetylcysteine, granulocyte-colonystimulating factor, and metadoxine, can be adjuvant therapies with a positive impact on patientsurvival. |
| format | Article |
| id | eprints-20052 |
| institution | UANL |
| language | English |
| publishDate | 2020 |
| record_format | eprints |
| spelling | eprints-200522024-12-09T18:36:29Z http://eprints.uanl.mx/20052/ The Mexican consensus on alcoholic hepatitis Velarde Ruiz Velasco, José Antonio Higuera de la Tijera, María de Fátima Castro Narro, Graciela Zamarripa Dorsey, F. Abdo Francis, J.M. Haddad, I. Aiza Aldana Ledesma, Juan Manuel Bielsa Fernández, María Victoria Cerda Reyes, Eira Cisneros Garza, Laura Esthela Contreras Omaña, Raul Reyes Dorantes, A. Fernández Pérez, Nicolas Joaquín García Jiménez, Edgar Santino Icaza Chávez, M. E. Kershenobich Stalnikowitz, David Lira Pedrín, M.A. Moreno Alcántar, Rosalba Pérez Hernández, J. L. Ramos Gómez, Mayra Virginia Rizo Robles, M.T. Solana Sentíes, S. Torre Delgadillo, Adriana RC Medicina Interna, Psiquiatría, Neurología Alcoholic hepatitis is a frequent condition in the Mexican population. It is characterized by acute-on-chronic liver failure, important systemic inflammatory response, and multiple organ failure. The severe variant of the disease implies elevated mortality. Therefore, the Asociación Mexicana de Gastroenterología and the Asociación Mexicana de Hepatología brought together a multidisciplinary team of health professionals to formulate the first Mexican consensus on alcoholic hepatitis, carried out utilizing the Delphi method and resultingin 37 recommendations. Alcohol-related liver disease covers a broad spectrum of patholo-gies that includes steatosis, steatohepatitis, different grades of fibrosis, and cirrhosis and itscomplications. Severe alcoholic hepatitis is defined by a modified Maddrey’s discriminant func-tion score ≥ 32 or by a Model for End-Stage Liver Disease (MELD) score equal to or above 21.There is currently no specific biomarker for its diagnosis. Leukocytosis with neutrophilia, hyper-bilirubinemia (>3 mg/dl), AST > 50 U/l (< 400 U/l), and an AST/ALT ratio > 1.5-2 can guide thediagnosis. Abstinence from alcohol, together with nutritional support, is the cornerstone oftreatment. Steroids are indicated for severe disease and have been effective in reducing the28-day mortality rate. At present, liver transplantation is the only life-saving option for patientsthat are nonresponders to steroids. Certain drugs, such as N-acetylcysteine, granulocyte-colonystimulating factor, and metadoxine, can be adjuvant therapies with a positive impact on patientsurvival. 2020 Article PeerReviewed text en cc_by_nc_nd http://eprints.uanl.mx/20052/1/1-s2.0-S2255534X20300542-main.pdf http://eprints.uanl.mx/20052/1.haspreviewThumbnailVersion/1-s2.0-S2255534X20300542-main.pdf Velarde Ruiz Velasco, José Antonio y Higuera de la Tijera, María de Fátima y Castro Narro, Graciela y Zamarripa Dorsey, F. y Abdo Francis, J.M. y Haddad, I. Aiza y Aldana Ledesma, Juan Manuel y Bielsa Fernández, María Victoria y Cerda Reyes, Eira y Cisneros Garza, Laura Esthela y Contreras Omaña, Raul y Reyes Dorantes, A. y Fernández Pérez, Nicolas Joaquín y García Jiménez, Edgar Santino y Icaza Chávez, M. E. y Kershenobich Stalnikowitz, David y Lira Pedrín, M.A. y Moreno Alcántar, Rosalba y Pérez Hernández, J. L. y Ramos Gómez, Mayra Virginia y Rizo Robles, M.T. y Solana Sentíes, S. y Torre Delgadillo, Adriana (2020) The Mexican consensus on alcoholic hepatitis. Revista de Gastroenterología de México (English Edition), 85 (3). pp. 332-353. ISSN 2255-534X http://doi.org/10.1016/J.RGMXEN.2020.04.004 doi:10.1016/J.RGMXEN.2020.04.004 |
| spellingShingle | RC Medicina Interna, Psiquiatría, Neurología Velarde Ruiz Velasco, José Antonio Higuera de la Tijera, María de Fátima Castro Narro, Graciela Zamarripa Dorsey, F. Abdo Francis, J.M. Haddad, I. Aiza Aldana Ledesma, Juan Manuel Bielsa Fernández, María Victoria Cerda Reyes, Eira Cisneros Garza, Laura Esthela Contreras Omaña, Raul Reyes Dorantes, A. Fernández Pérez, Nicolas Joaquín García Jiménez, Edgar Santino Icaza Chávez, M. E. Kershenobich Stalnikowitz, David Lira Pedrín, M.A. Moreno Alcántar, Rosalba Pérez Hernández, J. L. Ramos Gómez, Mayra Virginia Rizo Robles, M.T. Solana Sentíes, S. Torre Delgadillo, Adriana The Mexican consensus on alcoholic hepatitis |
| thumbnail | https://rediab.uanl.mx/themes/sandal5/images/online.png |
| title | The Mexican consensus on alcoholic hepatitis |
| title_full | The Mexican consensus on alcoholic hepatitis |
| title_fullStr | The Mexican consensus on alcoholic hepatitis |
| title_full_unstemmed | The Mexican consensus on alcoholic hepatitis |
| title_short | The Mexican consensus on alcoholic hepatitis |
| title_sort | mexican consensus on alcoholic hepatitis |
| topic | RC Medicina Interna, Psiquiatría, Neurología |
| url | http://eprints.uanl.mx/20052/1/1-s2.0-S2255534X20300542-main.pdf |
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