1. Alcohol-related Liver Disease and sepsis.
- Author
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Vassallo GA, Dionisi T, Tarli C, Augello G, Mirijello A, De Cosmo S, Gasbarrini A, and Addolorato G
- Subjects
- C-Reactive Protein analysis, Disease Susceptibility blood, Disease Susceptibility diagnosis, Humans, Liver Diseases, Alcoholic blood, Liver Diseases, Alcoholic immunology, Procalcitonin blood, Prognosis, Sepsis blood, Sepsis diagnosis, Sepsis drug therapy, Treatment Outcome, Anti-Bacterial Agents therapeutic use, Disease Susceptibility immunology, Liver Diseases, Alcoholic complications, Sepsis immunology
- Abstract
Objective: Sepsis is one of the most common complications and causes of death in patients with Alcohol-related Liver Disease. This narrative review will focus on several aspects of sepsis in the context of Alcohol-related Liver Disease. The pathophysiology of the increased susceptibility to infections consists mainly of impaired innate and adaptive immunity, changes in gut microbiota with consequent gut translocation of bacteria due to both alcohol abuse and the underlying liver disease. The diagnosis of sepsis in the context of Alcohol-related Liver Disease is challenging. Moreover, the use of classical acute-phase serum proteins (e.g., C-reactive protein and procalcitonin) has several limitations in this setting. The early administration of an adequate antibiotic treatment is pivotal. Finally, measures of infection control and prevention are needed because the prognosis of sepsis in patients affected by Alcohol-related Liver Disease is poor.
- Published
- 2021
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