4. 29 am report pearls: Alcohol related Cirrhosis


  • cirrhosis related to viral hepatitis is characteristically a small, shrunken liver
  • cirrhosis related to EtOH use is usually characterized by hepatomegaly
  • How much alcohol?
    • a man drinking 80 grams of alcohol daily will, on average, develop cirrhosis of the liver in 10 years
    • a woman drinking 80 grams daily of alcohol will, on average, develop cirrhosis in 5 years
      • one pint of wine, 3 12 oz beers, or 4 oz of distilled spirits is 20-40 grams of alcohol
      • the term “fifth of vodka” refers to when bottles were 4/5 of a quart which = 1/5 of a gallon.  Now we no longer measure bottles by the gallon, but 1/5 of a gallon is very close to 750 ml bottles
  • ferritin production is increased in the inflammatory state of alcoholic liver disease and acute or subacute hepatitis (from any cause).  In addition alcohol suppresses liver transferrin synthesis, elevating the serum transferrin saturation in alcoholic liver disease.
    • on biopsy, hepatic iron levels in those with alcoholic liver disease are relatively normal, especially in comparison to those with hemochromatosis

O’Shea RS, Dasarathy S, McCullough AJ, et al. Alcoholic liver disease. Hepatology 2010; 51:307.

Bird GL, Williams R. Factors determining cirrhosis in alcoholic liver disease. Mol Aspects Med 1988; 10:97.

Chapman RW, Morgan MY, Laulicht M, et al. Hepatic iron stores and markers of iron overload in alcoholics and patients with idiopathic hemochromatosis. Dig Dis Sci 1982; 27:909.


Evernote link: http://www.evernote.com/l/AoO_nJBWLMdAyqgelL3_IOXlVjuuZhhsug0/


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