De et al reported criteria for identifying a patient with severe alcoholic hepatitis. This can help to identify a patient at greater risk for complications. The authors are from the Medical College & Hospitals of Calcutta.



(1) daily alcohol intake in grams per day

(2) Maddrey discriminant function (DF)

(3) serum aspartate aminotransferase (AST, SGOT) in IU/L

(4) serum alanine aminotransferase (ALT, SGPT) in IU/L


ratio of AST to ALT =

= (serum AST) / (serum ALT)


Criteria for severe alcoholic hepatitis:

(1) history of chronic alcohol intake of > 50 grams per day

(2) Maddrey DF >= 32

(3) AST to ALT ratio > 2

(4) AST < 500 IU/L and ALT < 200 IU/L



• Alcohol intake is not adjusted for gender.


Ideally other causes of chronic liver disease should be excluded.


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