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. 1978 Jun;19(6):521–525. doi: 10.1136/gut.19.6.521

Recognition of alcoholic liver disease in a district general hospital.

A J Levi, D M Chalmers
PMCID: PMC1412045  PMID: 28269

Abstract

Two-hundred-and-two patients with alcoholic liver disease whose investigations included a liver biopsy were seen in a district general hospital over a seven year period. Thirty-five percent presented with general gastrointestinal symptoms rather than with overt liver disease or previously recognised excess consumption of alcohol. Recognition of the alcohol problem was assisted by the finding of a raised mean corpuscular volume (MCV) and/or gammaglutamyl transpeptidase (GGTP). The use of these methods of detection is discussed in relation to the rapid rise in alcohol consumption in the United Kingdom, and the high mortality of cirrhosis reported from special centres. Twnety-two per cent of the patients were found to have an established cirrhosis, and there was some evidence that the women were more susceptible to some of the toxic effects of alcohol. Early detection can be enhanced by a high level of suspicion, wider recognition of the significance of a high MCV, and the greater use of GGTP estimations.

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Selected References

These references are in PubMed. This may not be the complete list of references from this article.

  1. Ashley M. J., Olin J. S., le Riche W. H., Kornaczewski A., Schmidt W., Rankin J. G. Morbidity in alcoholics. Evidence for accelerated development of physical disease in women. Arch Intern Med. 1977 Jul;137(7):883–887. doi: 10.1001/archinte.137.7.883. [DOI] [PubMed] [Google Scholar]
  2. Brunt P. W., Kew M. C., Scheuer P. J., Sherlock S. Studies in alcoholic liver disease in Britain. I. Clinical and pathological patterns related to natural history. Gut. 1974 Jan;15(1):52–58. doi: 10.1136/gut.15.1.52. [DOI] [PMC free article] [PubMed] [Google Scholar]
  3. Dragosics B., Ferenci P., Pesendorfer F., Wewalka F. G. Gamma-glutamyltranspeptidase (GGTP): its relationship to other enzymes for diagnosis of liver disease. Prog Liver Dis. 1976;5:436–449. [PubMed] [Google Scholar]
  4. Eghöje K. N., Juhl E. Factors determining liver damage in chronic alcoholics. Scand J Gastroenterol. 1973;8(6):505–512. [PubMed] [Google Scholar]
  5. England J. M., Walford D. M., Waters D. A. Re-assessment of the reliability of the haematocrit. Br J Haematol. 1972 Aug;23(2):247–256. doi: 10.1111/j.1365-2141.1972.tb03477.x. [DOI] [PubMed] [Google Scholar]
  6. Glover S. C., McPhie J. L., Brunt P. W. Cholestasis in acute alcoholic liver disease. Lancet. 1977 Dec 24;2(8052-8053):1305–1307. doi: 10.1016/s0140-6736(77)90360-9. [DOI] [PubMed] [Google Scholar]
  7. Hamlyn A. N. Alcoholic liver disease in women. Br Med J. 1977 Apr 23;1(6068):1085–1086. doi: 10.1136/bmj.1.6068.1085-c. [DOI] [PMC free article] [PubMed] [Google Scholar]
  8. Krasner N., Davis M., Portmann B., Williams R. Changing pattern of alcoholic liver disease in Great Britain: relation to sex and signs of autoimmunity. Br Med J. 1977 Jun 11;1(6075):1497–1500. doi: 10.1136/bmj.1.6075.1497. [DOI] [PMC free article] [PubMed] [Google Scholar]
  9. Morgan M. Y., Sherlock S. Sex-related differences among 100 patients with alcoholic liver disease. Br Med J. 1977 Apr 9;1(6066):939–941. doi: 10.1136/bmj.1.6066.939. [DOI] [PMC free article] [PubMed] [Google Scholar]
  10. Rosalki S. B., Rau D. Serum -glutamyl transpeptidase activity in alcoholism. Clin Chim Acta. 1972 Jun;39(1):41–47. doi: 10.1016/0009-8981(72)90297-5. [DOI] [PubMed] [Google Scholar]
  11. Spring J. A., Buss D. H. Three centuries of alcohol in the British diet. Nature. 1977 Dec 15;270(5638):567–572. doi: 10.1038/270567a0. [DOI] [PubMed] [Google Scholar]
  12. Wilkinson P., Santamaria J. N., Rankin J. G. Epidemiology of alcoholic cirrhosis. Australas Ann Med. 1969 Aug;18(3):222–226. doi: 10.1111/imj.1969.18.3.222. [DOI] [PubMed] [Google Scholar]
  13. Wu A., Chanarin I., Levi A. J. Macrocytosis of chronic alcoholism. Lancet. 1974 May 4;1(7862):829–831. doi: 10.1016/s0140-6736(74)90482-6. [DOI] [PubMed] [Google Scholar]
  14. Wu A., Slavin G., Levi A. J. Elevated serum gamma-glutamyl-transferase (transpeptidase) and histological liver damage in alcoholism. Am J Gastroenterol. 1976 Apr;65(4):318–323. [PubMed] [Google Scholar]
  15. Zein M., Discombe G. Serum gamma-glutamyl transpeptidase as a diagnostic aid. Lancet. 1970 Oct 10;2(7676):748–750. doi: 10.1016/s0140-6736(70)90222-9. [DOI] [PubMed] [Google Scholar]

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