ALCOHOLIC LIVER DISEASE

factors influencing development & severity   of liver disease
 - Quantity of alcohol
 - Duration of consumption

 - Gender, women are more susceptible to        hepatic injury than men
 - Genetic
 - Iron overload & infections (HCV, HBV)

Diseases, 3 overlapping forms 

 - steatosis (fatty liver disease)

  * asymptomatic
  * hepatomegaly & mild elevation of serum bilirubin & alkaline phosphatase
 - hepatitis (minimal to fulminant)

 - cirrhosis

Pathogenesis

 - hepatocellular steatosis 
  * increased lipid biosynthesis
  * defect in assembly & secretion of lipoproteins
  * increased peripheral catabolism of fat
 - hepatitis
  *acetaldehyde induces disruption of cytoskeletal & membrane function      *reactive oxygen species react with cellular    proteins, & damage membranes
  * low hepatic glutathione>oxidative injury

Morphology

 - steatosis  
 - hepatitis
  * Hepatocyte swelling & necrosis
  * Mallory bodies
  * Neutrophil infiltration
  * Fibrosis
 - cirrhosis