[Alcoholic hepatitis: clinical, laboratorial and histological study of 50 cases]. / Hepatite alcoólica: estudo clínico, laboratorial e histológico de 50 casos.

The clinical, laboratorial and histological aspects of 50 cases of alcoholic hepatitis were analysed, as well as the follow-up of 24 patients. The mean age of the 50 patients was 42,9 years (range: 25 to 65 years); 44 were males. The beginning of the symptomatology was insidious in great number of cases. The hepatomegaly was most habitual clinical signal (92% of cases). The jaundice was observed in 58% of the cases. Twenty six per cent of the patients had not manifestation of advanced hepatopaty at the moment of diagnosis. The most constant laboratorial alteration (except the increase of gama-glutamil-transpeptidase, dosed in rare cases) was the increase of SGOT (94%). Histological examination showed necrosis and inflammatory exudate in all cases; steatosis in 98%; Mallory bodies in 78%; fibrosis in 84%; cirrhosis in 44%. In the group of patients that came to the obit at the first internation, jaundice, digestive bleeding, encephalopathy, infection, leucocitosis and decreased prothrombin activity. The follow-up of 24 cases (3 months to 5 years) showed aggravation of illness and frequent evolution to cirrhosis in patient that maintained the alcohol ingestion.

Hepatite alcoolica: estudo clinico, laboratorial e histologico de 50 casos. / Alcholic hepatitis: clinical, laboratorial and histological study of 50 cases

Os aspectos clinicos, laboratoriais e histologicos de 50 casos consecutivos de hepatite alcoolica sao analisados, bem como a evolucao tardia de 24 pacientes. Quarenta e quatro eram masculinos, a idade variando de 25 a 62 anos, com media de 42,9. Na maioria dos casos, o inicio da sintomatologia foi insidioso. A hepatomegalia foi o sinal clinico mais comum (92%); ictericia foi observada em 58% dos casos. Vinte e seis por cento dos pacientes nao apresentavam sinais ou sintomas sugestivos de hepatopatia avancada, na epoca do diagnostico. A alteracao laboratorial mais constante, excluindo a dosagem da gamaglutamil-transpeptidase (dosada em poucos casos), foi a elevacao da transaminase oxalacetica (94%). Histologicamente observamos necrose e infiltrado inflamatorio em todos os casos, esteatose em 98%, corpusculo de Mallory em 44%. No grupo que evoluiu para o obito na primeira internacao, foram significativamente mais frequentes a ictericia, hemorragia digestiva, encefalopatia, sinais de infeccao leucocitose e baixa atividade de protrombina.Em 24 casos acompanhados (3 meses a 5 anos) observou-se piora do quadro e alta frequencia de evolucao para cirrose, nos pacientes que mantiveram o alcoolismo