Chinese Medical Information Portal Website (Taiwan Medical Network-TMN) - OldDoc Wu's Series
(Established in March 1996)
Dr. Wu's Liver diseases
for professionals (medical students and residents)
(Posted Sep. 16, 1996; Updated May 14, 2009)
Alcoholic liver disease
[Dr. Wu's Health Note- Home]
[Taiwan Medical Network]
(Key words: alcoholic liver disease, alcoholic hepatitis, alcoholic cirrhosis)
- Alcoholic liver disease is a condition of liver cell damage induced by large amount and long period of alcohol consumption.
- It will progress to acute alcoholic hepatitis, chronic hepatitis and finally cirrhosis. Only a few of the victims will progress further to hepatocellular carcinoma.
- Symtoms and signs: enlargement of the liver, and there will be icterus, enlargement of spleen, engorgement of abdominal superficial veins, ascites and lower leg edema in cirrhotic cases.
- The laboratory test shows elevated serum gammaglutamyl transpeptidase (GGTP), transaminase (GOT=AST, GPT=ALT, GOT>GPT), bilirubin, and globulin. Serum albumin will decrease in advanced cirrhotic cases.
- The cause of death usually is hepatic failure or hematoemesis due to rupture of esophageal varicose vein.
- Treatment: withdrawal from alcohol, symptomatic treatment of heaptic failure.
- Alcoholic liver disease is the primary liver disease among Caucasians, while the most common liver disease is hepatitis virus infection (Hepatitis A, B, C, D) among Orientals.
- In Canada and U.S.A. the mortality of liver cirrhosis ranks the third to fifth main causes of dealth of adult populations, and is mostly due to alcohol consumption.
- In European countries, the prevalence of liver disease correlates well with the amount of alcohol consumption, therefore we may estimate the amount of alcohol consumption from the yearly death rate of liver cirrhosis.
- In Western countries, total alcohol consumption showed a trend of decrease before the WWII, but after the WWII it kept the tendency of increase till the highest in 1975. Since 1975 the trend showed distinct decline again, and the prevalence of liver disease varied in correlation with the change in the amount of alcohol consumption.
- In Taiwan, the alcohol consumtion has increased since the early 1960's. By 1991 it has increased 11 % as compared with that of 1976. It means per capita yearly consumption of 3.5 liters 100 % pure alcohol. However, it is only 1/4 ~ 1/5 or 1/2 of the amount cosumed in France or U.S.A.
- The alcoholic liver disease is unrelated to the type of alcohol beverages consumed. Beer, brandy, wine, wiskey, and all kinds of liquors will induce the liver disease samely. They cause liver disease depends on the total amount and duration of alcohol consumption.
Amount of alcohol that may be of risk
Metabolism of ethanol
- The amount of daily alcohol consumption that may induce liver cirrhosis:
- Females are easier to become cirrhotic than males, and the risky amount of alcohol for females is much smaller i.e.1/2 of that for males.
Histopathoplogical features of alcoholic liver disease
- 1) Fatty liver:
- Fatty degeneration (deposit, accumulation of fat) in the liver cells: commonly seen in alcoholic liver disease.
- Weight of the liver may be over 2.0 - 2.5 Kg.
- The hepatocytes are enlarged with large fat vacuoles displacing the nucleus eccentrically.
- 2) Fibrosis:
- Perivenular necrosis and fibrosis.
- 3) Alcoholic hepatitis:
- Inflammatory necrosis = steatonecrosis-Mallory type, steatohepatitis
- PMN (polymorphonuclear cell) reaction, mostly around the perivenular region
- Mallory's alcohol hyaline body
- 4) Cirrhosis:
- Micronodular or Laennec's cirrhosis
Pure ethanol concentration of alcoholic beverages in Taiwan (1992)
(A) Rice wine
(D) Rice liquer
[Web sites for medical students][Curriculum Vitae ]
(By Jau-Shin Wu, M.D.; Posted Sep. 16, 1996; Revised May 12, 2009)
(TMN) Since June 09, 2002
(Dr. Wu's Liver D) Since Jan. 01, 2008
(Olddoc)Since Jan. 01, 2008
(TMN) Since Jan. 01, 2008