Investigation on new aspects of diagnosis and natural history of severe forms of alcohol-associated liver disease

[eng] INTRODUCTION: Alcohol-related liver disease (ALD) is the leading cause of cirrhosis in the world and the leading cause of death from liver disease in Europe. Alcohol-associated hepatitis (AH) is a severe form of MHA; The gold-standard for diagnosis is the histological analysis of the liver in...

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Detalles Bibliográficos
Autor: Gratacós Ginès, Jordi
Tipo de recurso: tesis doctoral
Estado:Versión publicada
Fecha de publicación:2024
País:España
Institución:Universidad de Barcelona
Repositorio:Dipòsit Digital de la UB
OAI Identifier:oai:diposit.ub.edu:2445/214627
Acceso en línea:https://hdl.handle.net/2445/214627
http://hdl.handle.net/10803/691807
Access Level:acceso abierto
Palabra clave:Malalties del fetge
Hepatopaties alcohòliques
Cirrosi hepàtica
Biòpsia
Liver diseases
Alcoholic liver diseases
Hepatic cirrhosis
Biopsy
Descripción
Sumario:[eng] INTRODUCTION: Alcohol-related liver disease (ALD) is the leading cause of cirrhosis in the world and the leading cause of death from liver disease in Europe. Alcohol-associated hepatitis (AH) is a severe form of MHA; The gold-standard for diagnosis is the histological analysis of the liver in an appropriate clinical context, but currently the diagnosis is usually based on clinical and analytical criteria in most cases. However, there are other liver diseases, such as alcohol-induced foamy degeneration of the liver (DEFA), which can occur in a similar way and are not usually taken into account in the differential diagnosis of AH. As for the long-term prognosis after an episode of HA, it is known that abstinence from alcohol plays a fundamental role. Although patients who have suffered from AH have a tendency to resume alcohol consumption during follow-up, the incidence and characteristics of recurrent episodes of AH are unknown. In addition, with regard to medications that promote alcohol withdrawal, little is known about their efficacy and safety in patients with MHA. HYPOTHESIS: The first hypothesis is that the differential diagnosis of AH with DEFA is important in order to establish prognosis and treatment. The second, that alcohol consumption in advanced stages of MHA is associated with important clinical complications such as recurrence of HA. OBJECTIVES: In general, to increase knowledge regarding the diagnosis and natural history of the severe forms of presentation of MHA. Specifically, to determine the prevalence of DEFA in cases of clinical suspicion of AH, to search for new non-invasive tools for differential diagnosis and to determine the prognosis and genetic signature at the hepatic level of patients with DEFA. Likewise, to describe the incidence, characteristics and prognostic impact of HA recurrences; and to determine the efficacy and safety of TUA medications in patients with advanced MHA.