Alcoholic Liver Disease - B. Pharma 2nd Semester Pathophysiology notes pdf

Alcoholic Liver Disease


       Alcoholic Liver Disease



       Laboratory Diagnosis


At the end of this session, student will be able to –

       Explain the Pathogenesis of Alcoholic Liver Disease

       Describe the Symptoms of Alcoholic Liver Disease

       Explain various laboratory diagnosis test for Alcoholic liver Disease

Alcoholic Liver Disease

Alcoholic liver disease is the term used to describe the spectrum of liver injury associated with acute and chronic alcoholism

Signs and Symptoms

       Progresses in the liver as inflammation (hepatitis) and leads to fatty liver and cirrhosis

Risk factors

       Occurs after many years of excessive drinking

       Acute alcoholic hepatitis – Binge drinking

       Severe drinking – Life threatening

       Genetic factors - Women have increased susceptibility to develop advanced alcoholic liver disease with much lesser alcohol intake


       Toxicity of ethanol in liver

       Infection – Hepatitis C infection

Distinctive forms of Alcoholic Liver Disease

Hepatic Steatosis (Fatty liver)

          Moderate consumption - Deposition of small lipid droplets in hepatocytes

          Excessive consumption – accumulation of lipids in macrovascular  droplets

          Nucleus gets displaced, Enlarged liver

Alcoholic hepatitis

          Necrosis of liver cells in centrilobular region

          Neutrophillic reaction


Alcoholic Cirrhosis

          Irreversible - Final stage

          Liver turns brown, shrunken and non-fatty appearance

          Resembles post necrotic cirrhosis 

Pathogenesis of Alcoholic Liver Disease

Ethanol Metabolism

ADH = Alcohol Dehydrogenase; ALDH or ACDH = Hepatic Acetaldehyde Dehydrogenase; NAD = Nicotinamide Adenine Dinucleotide; NADH = Reduced NAD

       Direct hepatotoxicity by ethanol to microtubules, mitochondria, membrane hepatocytes

       Hepatotoxicity by ethanol metabolites

      Production of protein-aldehyde adducts

      Formation of malo-di-aldehyde-acetaldehyde (MAA)

       Oxidative Stress -  oxidation of ethanol by cytochrome 450 oxidase, generation of free radicals and oxidative damage

       Immunological attacks on hepatocytes


      Damaged hepatocytes,

      Malon-di-aldehyde-acetaldehyde adducts,

      Activated kupffer cells, and

      Direct stimulation by acetaldehyde

Laboratory Diagnosis For Alcoholic Liver Disease

       Elevated transaminases: increase in SGOT (AST) is more than that of SGPT (ALT)

       Rise in serum γ-glutamyl transpeptidase (γ-GT)

       Elevation in Serum alkaline phosphatase


       Hypoproteinaemia with reversal of albumin-globulin ratio

       Prolonged prothrombin time and partial thromboplastin time

       Anemia and Neutrophilic leucocytosis


       Alcohol liver disease is damage to liver and its function due to alcohol abuse

       Progresses in the liver as inflammation (hepatitis) and leads to fatty liver and cirrhosis

       Major forms include hepatic steatosis, hepatitis, cirrhosis

       Alcohol is a caloric food source which displaces nutrients

       Causes the activation of Kupffer cells and release of proinflammatory mediators

Post a Comment