medigraphic.com
Órgano Oficial de la Asociación Mexicana de Hepatología

2012, Number 3

<< Back Next >>

Ann Hepatol 2012; 11 (3)

Hepatic hemodynamics and transient elastography in alcoholic foamy degeneration: report of 2 cases

Ruiz P, Michelena J, Altamirano J, Miquel R, Moreira L, Cárdenas A, Abraldes JG, Brugera M, Arroyo V, Ginès P, Caballería J, Bataller R

Language: English
References: 20
Page: 399-403
PDF size: 122.68 Kb.


ABSTRACT

Alcoholic liver disease (ALD) covers a wide spectrum of pathology ranging from fatty liver disease to acute steatohepatitis to cirrhosis and/or hepatocellular carcinoma. Alcoholic foamy degeneration (AFD) is an uncommon, potentially life-threatening condition that is part of the spectrum of ALD. It is characterized by extensive microvesicular steatosis in the perivenular areas. Since the first description in 1983, few case reports have been described. Here, we report 2 cases of AFD in patients with a previous history of chronic alcohol abuse and histological diagnosis of AFD with typical clinical, biochemical and histological features. In both cases we provide data on the hepatic hemodynamic status, and in one of them we report liver elastography results, which are features that have not been described previously. In both cases there was rapid resolution of biochemical and clinical abnormalities after complete abstinence, which is the mainstay of treatment for AFD.


REFERENCES

  1. Uchida T, Kao H, Quispe-Sjogren M, et al. Alcoholic foamy degeneration. A pattern of acute alcoholic injury of the liver. Gastroenterology 1983; 84: 683-92.

  2. Montull S, Pares A, Brugera M, et al. Alcoholic foamy degeneration in Spain. Prevalence and clinico-pathological features. Liver 1989; 9: 79-85.

  3. Suri S, Mitros FA, Ahluwalia JP. Alcoholic foamy degeneration and a markedly elevated GGT: a case report and literature review. Dig Dis Sci 2003; 48: 1142-6.

  4. Bataller R, Rombouts K, Altamirano J, et al. Fibrosis in alcoholic and nonalcoholic steatohepatitis. Best Pract Res Clin Gastroenterol 2011; 25: 231-44.

  5. International Group. Alcoholic liver disease: morphologic manifestations. Lancet 1981; i: 707-11.

  6. Koyama W, Kanayama M, Uchida T, et al. Serial liver biopsies of two patients with alcoholic foamy degeneration. Kanzo Acta Hepatol Jpn 1984; 25: 657-65.

  7. Fléjou JF, Degott C, Kharsa G, et al. Alcoholic foamy steatosis: study of 3 cases. Gastroenterol Clin Biol 1987; 11: 165-8.

  8. Kondili LA, Taliani G, Cerga G, et al. Correlation of alcohol consumption with liver histological features in non-cirrhotic patients. Eur J Gastroenterol Hepatol 2005; 17: 155-9.

  9. Lai CL, Ng RP, Lok ASF: The diagnostic value of the ratio of serum gamma glutamyl transpeptidase to alkaline phosphatase in alcoholic liver disease. Scand J Gastroenterol 1982; 17: 41-7.

  10. Sabesin SM, Hawkins HL, Kuiken L, et al. Abnormal plasma lipoproteins and lecithin-cholesterol acyltransferase deficiency in alcoholic liver disease. Gastroenterology 1977; 72: 510-8.

  11. Muller P, Fellin R, Lambrect J, et al. Hypertriglyceridemia secondary to liver disease. Eur J Clin Invest 1974; 4: 419-28.

  12. Yip WW, Burt AD. Alcoholic liver disease. Semin Diagn Pathol 2006; 23: 149-60.

  13. Rincon D, Lo Iacono O, Ripoll C, et al. Prognostic value of hepatic venous pressure gradient for in-hospital mortality of patients with severe acute alcoholic hepatitis. Aliment Pharmacol Ther 2007; 25: 841-8.

  14. Lucey MR, Mathurin P, Morgan TR. Alcoholic hepatitis. N Engl J Med 2009; 360: 2758-69.

  15. Poynard T, Degott C, Munoz C, et al. Relationship between degree of portal hypertension and liver histologic lesions in patients with alcoholic cirrhosis. Effect of acute alcoholic hepatitis on portal hypertension. Dig Dis Sci 1987; 32: 337-43.

  16. Orrego H, Blendis LM, Crossley IR, et al. Correlation of intrahepatic pressure with collagen in the Disse space and hepatomegaly in humans and in the rat. Gastroenterology 1981; 80: 546-56.

  17. Navasa M, Garcia-Pagan JC, Bosch J, et al. Portal hypertension in acute liver failure. Gut 1992; 33: 965-8.

  18. Fraquelli M, Rigamonti C, Casazza G, et al. Reproducibility of transient elastography in the evaluation of liver fibrosis in patients with chronic liver disease. Gut 2007; 56: 968-73.

  19. Millonig G, Reimann FM, Friedrich S, et al. Extrahepatic cholestasis increases liver stiffness (FibroScan) irrespective of fibrosis. Hepatology 2008; 48: 1718-23.

  20. Millonig G, Friedrich S, Adolf S, et al. Liver stiffness is directly influenced by central venous pressure. J Hepatol 2010; 52: 206-10.




2020     |     www.medigraphic.com