Clinical and pathological studies in severe alcoholic hepatitis

Clinical and histological features in 8 cases with severe alcoholic hepatitis (SAH) were analysed and compared with those in 65 cases with non-severe alcoholic hepatitis (AH). All of 8 cases with SAH had less than 50% of prothrombin value, 7 cases with SAH showed hepatic encephalopathy and 7 cases died of complications such as pneumonia, renal failure and gastro-intestinal bleeding within one month after the abstinence. All cases with SAH showed remarkable hepatomegaly above 2 FB under the right costal margin and leucocytosis above 10, 000/mm3. 4 of 7 cases with SAH had fever, elevated serum BUN and creatinine levels. Endotoxemia was found in all cases with SAH examined. Circulatory immune complex was also frequently detected in cases with SAH. Hepatic scintigram using 99mTc-Phytate showed remarkably decreased hepatic uptake of radioisotope in cases with SAH. It was suggested that SAH had depressed reticulo-endothelial function which resulted in endotoxemia and multiple organ failure.