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Pathology definition - Alcoholic Liver Disease
Alcoholic liver disease
There are three form of alcoholic liver disease which are divided pathologically. These include hepatic steatosis, alcoholic hepatitis and alcoholic cirrhosis.
Hepatic steatosis commonly presented with elevation of the liver enzyme ALP with mild hyperbilirubinemia. Hepatic steatosis mostly present as an early but reversible changes of the hepatocytes. There is an accumulation of the lipid droplets in the centrilobular hepatocytes and the liver appear yellowish and greasy in color.
Accumulation of lipid/fat in the hepatocytes is also associated with Fatty liver syndrome which is also known as Reye syndrome ( due to salicylate and viral infection in chidlren), kwashiorkor, diabetes, hepatic failure, tetracycline toxicity and malabsorption syndromes.
Alcoholic hepatitis mostly present as fibrosis of the perivenular and sinusoidal, swelling and necrosis of the hepatocytes, the present of intracytoplasmic eosinophilic hyaline bodies/ Mallory bodies and infiltration of the hepatocytes by neutrophil. Alcoholic hepatitis occur due to bout of heavy drinking. Alcoholic hepatitis may present with raised in the ratio of the liver enzyme ALT: AST by more than 1.5. Patient with alcoholic hepatitis will complain of pain in the abdomen and anorexia. Hepatomegaly and leukocytosis are the common physical signs and laboratory investigation findings.
Alcoholic cirrhosis may present with loss of architecture of the liver with hobnail appearance ( irregular nodules) and fibrotic liver. Alcoholic cirrhosis may also present with shrunken used to be fatty large liver. Patient with alcoholic cirrhosis may present with ascites and jaundice. Portal hypertension may occur as one of the complication and liver enzymes may be elevated in cases of alcoholic cirrhosis.
Alcoholic liver disease may affect mostly women and due to excessive consumption of alcohol ( ethanol). The treatment of alcoholic liver disease may include , methylprednisolone, folate and thiamine vitamin supplement, nutritional support and abstinence from alcohol.
References
1.Yip, William W., and Alastair D. Burt. “Alcoholic Liver Disease.” Seminars in Diagnostic Pathology 23, no. 3 (August 2006): 149–160. doi:10.1053/j.semdp.2006.11.002.
2.O’Shea, Robert S., Srinivasan Dasarathy, Arthur J. McCullough, Practice Guideline Committee of the American Association for the Study of Liver Diseases, and the Practice Parameters Committee of the American College of Gastroenterology. “Alcoholic Liver Disease.” Hepatology 51, no. 1 (2010): 307–328. doi:10.1002/hep.23258.
There are three form of alcoholic liver disease which are divided pathologically. These include hepatic steatosis, alcoholic hepatitis and alcoholic cirrhosis.
Hepatic steatosis commonly presented with elevation of the liver enzyme ALP with mild hyperbilirubinemia. Hepatic steatosis mostly present as an early but reversible changes of the hepatocytes. There is an accumulation of the lipid droplets in the centrilobular hepatocytes and the liver appear yellowish and greasy in color.
Accumulation of lipid/fat in the hepatocytes is also associated with Fatty liver syndrome which is also known as Reye syndrome ( due to salicylate and viral infection in chidlren), kwashiorkor, diabetes, hepatic failure, tetracycline toxicity and malabsorption syndromes.
Alcoholic hepatitis mostly present as fibrosis of the perivenular and sinusoidal, swelling and necrosis of the hepatocytes, the present of intracytoplasmic eosinophilic hyaline bodies/ Mallory bodies and infiltration of the hepatocytes by neutrophil. Alcoholic hepatitis occur due to bout of heavy drinking. Alcoholic hepatitis may present with raised in the ratio of the liver enzyme ALT: AST by more than 1.5. Patient with alcoholic hepatitis will complain of pain in the abdomen and anorexia. Hepatomegaly and leukocytosis are the common physical signs and laboratory investigation findings.
Alcoholic cirrhosis may present with loss of architecture of the liver with hobnail appearance ( irregular nodules) and fibrotic liver. Alcoholic cirrhosis may also present with shrunken used to be fatty large liver. Patient with alcoholic cirrhosis may present with ascites and jaundice. Portal hypertension may occur as one of the complication and liver enzymes may be elevated in cases of alcoholic cirrhosis.
Alcoholic liver disease may affect mostly women and due to excessive consumption of alcohol ( ethanol). The treatment of alcoholic liver disease may include , methylprednisolone, folate and thiamine vitamin supplement, nutritional support and abstinence from alcohol.
References
1.Yip, William W., and Alastair D. Burt. “Alcoholic Liver Disease.” Seminars in Diagnostic Pathology 23, no. 3 (August 2006): 149–160. doi:10.1053/j.semdp.2006.11.002.
2.O’Shea, Robert S., Srinivasan Dasarathy, Arthur J. McCullough, Practice Guideline Committee of the American Association for the Study of Liver Diseases, and the Practice Parameters Committee of the American College of Gastroenterology. “Alcoholic Liver Disease.” Hepatology 51, no. 1 (2010): 307–328. doi:10.1002/hep.23258.
