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Abstract: The patient was a 57-year-old male with no previous history of hepatitis and no history of medication, but he was a long-term heavy drinker. In the past 5 days, he suddenly developed yellow eyes, yellow urine, abdominal distension and poor appetite, and his liver function bilirubin and gamma glutamyl transpeptidase were significantly elevated on laboratory tests, which was considered to be alcoholic liver disease. His treatment mainly consisted of abstinence from alcohol and medication. After treatment, his condition has been controlled and all indicators are improving.
Basic information】Male, 57 years old
Type of disease】Alcoholic liver disease
Hospital】The 988th Hospital of the PLA Joint Logistics and Security Forces
Time of consultation】September 2020
Treatment plan】Medication (magnesium isoglycyrrhizate injection + polyene-phosphatidylcholine injection + adenosylmethionine butadisulfate for injection) + alcohol withdrawal
Treatment period】3 weeks of inpatient treatment, 1 month of outpatient follow-up
Treatment effect】The disease has been controlled, and all indicators are improving
I. Initial consultation
A 57-year-old male patient came to the clinic complaining of sudden onset of yellow eyes, yellow urine and abdominal distension in recent days, and eating half as much as before, and liver function was not normal. After detailed medical history, the patient had no history of chronic hepatitis in the past, but was a long-term alcoholic.
II. Treatment history
The patient had no previous history of chronic hepatitis, but in the past 5 days, he had obvious abdominal distension, poor diet, yellow urine, and a history of long-term alcoholism. Although his own symptoms were short-lived, the analysis of liver function results showed that the white globule ratio was inverted, γ-glutamyl transpeptidase was significantly elevated, and platelets were 88×10^9/L, which was a chronic process of disease development, and the infection of hepatitis B and C was excluded. Therefore, the patient was given magnesium isoglycyrrhizate injection to control the inflammation of liver cells, polyenyl phosphatidylcholine injection to protect the liver cell membrane, adenosylmethionine butadisulfate for injection to fight against cholestasis, and told to abstain from alcohol, which is the key and the first and most important link in the treatment of alcoholic liver disease, and was also instructed to give a high-calorie, high-protein, low-fat diet and pay attention to multivitamin supplementation to enhance nutrition.
III. Treatment effect
After 3 weeks of treatment with liver protection and yellowing reduction, together with the patient’s abstinence from alcohol, complete removal of the causative factors from the root and strengthening of nutritional support, the patient’s yellow eyes and urine were relieved, his diet returned to normal, and he did not have any more symptoms such as abdominal distension, etc. The review of liver function showed that bilirubin decreased significantly, albumin returned to normal, and mental and physical status also improved significantly.
IV. Notes
We are glad that after active treatment, the patient’s condition has been reversed, but still requires 1 month of outpatient follow-up. Although the patient is currently well treated, he still needs to abstain from alcohol. Abstinence from alcohol is currently the most effective measure to prevent and treat alcoholic liver disease, and in order to get better treatment results, it is necessary to completely abstain from alcohol. Only by completely removing the cause of the disease can the patient’s condition be effectively treated and improve the malnutrition status, and the diet is based on a multi-calorie, multi-protein and low-fat diet. If there is a combination of cirrhosis, anti-cirrhosis treatment is also required. The liver function and abdominal ultrasound will be reviewed every 3 months to keep abreast of the changes in the condition.
V. Personal insight
Alcoholic liver disease is caused by long-term alcohol abuse, initially manifested as fatty liver, if through interventions such as abstinence from alcohol, good results can be achieved, if no abstinence from alcohol, it can develop into alcoholic hepatitis, alcoholic cirrhosis, and in serious cases, liver failure. However, do not be afraid of alcoholic liver disease when it occurs. Abstinence from alcohol is the basis for the treatment of alcoholic liver disease, and in addition to abstinence from alcohol, it is also necessary to actively and adequately give nutritional support, actively supplement vitamins, and reasonably apply liver-protective drugs. However, the patient had once thought that drinking only affected his poor appetite and did not realize that he had developed alcoholic liver disease. Long-term drinkers are advised to recognize the harmful effects of alcohol and avoid such diseases.