Gastroenterology and hepatology
Alcohol-induced hepatitis
NIAAA criteria, severity by Maddrey and MELD, the infection screen before prednisolone, the Lille stopping rule, what doesn't work, and treating the alcohol use disorder that decides survival.
Tier 1Condition
Written with AI assistance and fact-checked against the sources below. For exam study, not clinical decisions. How notes are made
At a glance
- Jaundice of recent onset in someone drinking heavily, often with fever, tender hepatomegaly and a neutrophilia. Most have underlying cirrhosis.
- Diagnosis is usually clinical, using the NIAAA criteria. Biopsy only when the picture is unclear.
- Severe disease (Maddrey 32 or more, MELD over 20) carries about 20 to 30% mortality at 90 days.
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Sources
- Jophlin LL et al. ACG Clinical Guideline: Alcohol-Associated Liver Disease. Am J Gastroenterol 2024;119:30-54American College of Gastroenterology, 2024
- Crabb DW et al. Diagnosis and Treatment of Alcohol-Associated Liver Diseases: 2019 Practice Guidance From the American Association for the Study of Liver Diseases. Hepatology 2020;71:306-33American Association for the Study of Liver Diseases, 2019
- EASL Clinical Practice Guidelines: Management of alcohol-related liver disease. J Hepatol 2018;69:154-81European Association for the Study of the Liver, 2018
- Thursz MR et al. Prednisolone or pentoxifylline for alcoholic hepatitis (STOPAH). N Engl J Med 2015;372:1619-28New England Journal of Medicine, 2015
- Australian guidelines to reduce health risks from drinking alcoholAU/NZNational Health and Medical Research Council, 2020
- Campral (acamprosate calcium) product informationAU/NZSponsor product information (medsinfo)
- Last updated
- 14 November 2026
What changed
- 14 November 2026 Personal emails, About story and Australian-style copy