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Plasma Tumor Necrosis Factor α Predicts Decreased Long‐Term Survival in Severe Alcoholic Hepatitis
Author(s) -
Felver Michael E.,
Mezey Esteban,
McGuire Marielena,
Mitchell Mack C.,
Herlong H. Frank,
Veech George A.,
Veech Richard L.
Publication year - 1990
Publication title -
alcoholism: clinical and experimental research
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 1.267
H-Index - 153
eISSN - 1530-0277
pISSN - 0145-6008
DOI - 10.1111/j.1530-0277.1990.tb00482.x
Subject(s) - alcoholic hepatitis , tumor necrosis factor alpha , medicine , alcoholic liver disease , term (time) , gastroenterology , immunology , oncology , physics , cirrhosis , quantum mechanics
Plasma tumor necrosis factor α (TNF α), interleukin 1 α (IL‐1α), and interleukin 1 β (IL‐1β) were measured in plasma samples obtained from 23 patients with severe alcoholic hepatitis on admission and after 30 days of hospitalization. Over a 2‐year follow‐up period, 14 patients died at a mean time of 8 months following discharge. The presence of elevated plasma TNF α either at admission or discharge from the hospital was associated with death in 82% (14/17) of patients. By contrast absence of elevated plasma TNF α was associated with survival in 100% (6/6). The difference in survival with and without detectable plasma TNF α was significant at p = 0.0022. Plasma TNF α was not elevated in alcoholic patients without clinically apparent liver disease, with alcoholic cirrhosis, or in nonalcoholic healthy controls. Plasma IL‐1a was also significantly increased in alcoholic hepatitis whereas IL‐1β was not. Neither IL‐1α nor β was correlated with outcome in the alcoholic hepatitis group. It is concluded that the presence of elevated plasma TNF α is a significant predictor of decreased long‐term survival in patients with severe alcoholic hepatitis.