SEVERE ALCOHOLIC HEPATITIS IN AN INDONESIAN ADOLESCENT : A RARE AND PREVENTABLE CASE OF CHRONIC ETHANOL ABUSE
DOI:
https://doi.org/10.31004/prepotif.v9i2.48179Keywords:
cedera hati, hepatitis alkoholik, kasus, konsumsi alkohol kronis, remajaAbstract
Hepatitis alkoholik (HA) adalah kondisi inflamasi akut pada hati yang disebabkan oleh konsumsi alkohol yang berlebihan dan berkepanjangan, yang umumnya terjadi pada orang dewasa. Kejadian HA pada remaja sangat jarang dan menimbulkan kekhawatiran yang signifikan dalam konteks klinis maupun kesehatan masyarakat. Kami melaporkan kasus seorang remaja laki-laki berusia 17 tahun asal Indonesia dengan riwayat konsumsi alkohol secara rutin selama dua tahun terakhir, yang datang dengan keluhan nyeri perut kuadran kanan atas, ikterus, urine berwarna coklat seperti teh, kelelahan, dan demam ringan. Pemeriksaan fisik menunjukkan sklera ikterik dan nyeri tekan epigastrium. Hasil laboratorium menunjukkan peningkatan kadar transaminase serum (SGOT 458 U/L, SGPT 1282 U/L) dan hiperbilirubinemia (bilirubin total 10,47 mg/dL), dengan serologi hepatitis virus yang negatif. Pemeriksaan USG dan CT scan menunjukkan adanya asites dan efusi pleura bilateral tanpa adanya massa hati atau obstruksi bilier. Pasien mendapatkan terapi suportif berupa cairan intravena, antibiotik, agen pelindung lambung, dan terapi pendukung fungsi hati, dengan perbaikan klinis dan biokimia yang signifikan dalam waktu satu minggu.Kasus ini menyoroti pentingnya mengenali hepatitis alkoholik pada populasi remaja, terutama mereka yang memiliki riwayat konsumsi alkohol tersembunyi namun kronis. Identifikasi dini, perawatan multidisipliner, dan edukasi pencegahan terhadap bahaya alkohol sangat penting untuk mencegah komplikasi dan kekambuhan.References
Agarwal, K., Kontorinis, N., & Dieterich, D. T. (2023). Alcoholic-Associated Hepatitis. Current Treatment Options in Gastroenterology, 7(6), 451–458. https://doi.org/10.1007/s11938-004-0004-6
Danpanichkul, P., Chen, V. L., Tothanarungroj, P., Kaewdech, A., Kanjanakot, Y., Fangsaard, P., Wattanachayakul, P., Duangsonk, K., Kongarin, S., Yang, J. D., Wong, R. J., Noureddin, M., Díaz, L. A., Arab, J. P., Liangpunsakul, S., & Wijarnpreecha, K. (2024). Global epidemiology of alcohol-associated liver disease in adolescents and young adults. Alimentary Pharmacology & Therapeutics, 60(3), 378–388. https://doi.org/10.1111/APT.18101
Dugum, M., & McCullough, A. (2015). Diagnosis and Management of Alcoholic Liver Disease. Journal of Clinical and Translational Hepatology, 3(2), 109. https://doi.org/10.14218/JCTH.2015.00008
Flemming, J. A., Djerboua, M., Chapman, O., Ayonrinde, O., & Terrault, N. A. (2024). Epidemiology and Outcomes of Alcohol-Associated Hepatitis in Adolescents and Young Adults. JAMA Network Open, 7(12), e2452459–e2452459. https://doi.org/10.1001/JAMANETWORKOPEN.2024.52459
Girish, V., Mousa, O. Y., Syed, K., & John, S. (2025). Acute on Chronic Liver Failure. Gastroenterology For General Surgeons, 159–173. https://doi.org/10.1007/978-3-319-92768-8_14
Gustot, T., & Jalan, R. (2019). Acute-on-chronic liver failure in patients with alcohol-related liver disease. Journal of Hepatology, 70(2), 319–327. https://doi.org/10.1016/J.JHEP.2018.12.008/ASSET/58749E04-FAD5-44E1-88F0-3777C7B8FBEC/MAIN.ASSETS/GR2.JPG
Hagström, H., Hemmingsson, T., Discacciati, A., & Andreasson, A. (2018). Alcohol consumption in late adolescence is associated with an increased risk of severe liver disease later in life. Journal of Hepatology, 68(3), 505–510. https://doi.org/10.1016/J.JHEP.2017.11.019
Kasper, P., Lang, S., Steffen, H. M., & Demir, M. (2023). Management of alcoholic hepatitis: A clinical perspective. Liver International, 43(10), 2078–2095. https://doi.org/10.1111/LIV.15701;PAGEGROUP:STRING:PUBLICATION
Keating, M., Lardo, O., & Hansell, M. (2022). Alcoholic Hepatitis: Diagnosis and Management. American Family Physician, 105(4), 412–420. https://www.aafp.org/pubs/afp/issues/2022/0400/p412.html
Khemichian, S., & Donovan, J. A. (2023). Alcohol-Associated Liver Disease. Gut Instincts: A Clinician’s Handbook of Digestive and Liver Diseases, 251–256. https://doi.org/10.1201/9781003524489-39
Mavis, A. M., & Alonso, E. M. (2014). Liver Disease in the Adolescent. Clinics in Liver Disease, 19(1), 171. https://doi.org/10.1016/J.CLD.2014.09.010
Morales-Arráez, D., Ventura-Cots, M., Altamirano, J., Abraldes, J. G., Cruz-Lemini, M., Thursz, M. R., Atkinson, S. R., Sarin, S. K., Kim, W., Chavez-Araujo, R., Higuera-De La Tijera, M. F., Singal, A. K., Shah, V. H., Kamath, P. S., Duarte-Rojo, A., Charles, E. A., Vargas, V., Jager, M., Rautou, P. E., … Bataller, R. (2022). The MELD Score Is Superior to the Maddrey Discriminant Function Score to Predict Short-Term Mortality in Alcohol-Associated Hepatitis: A Global Study. American Journal of Gastroenterology, 117(2), 301–310. https://doi.org/10.14309/AJG.0000000000001596,
Philips, C. A., Augustine, P., Yerol, P. K., Rajesh, S., & Mahadevan, P. (2019). Severe alcoholic hepatitis: current perspectives. Hepatic Medicine: Evidence and Research, 11, 97–108. https://doi.org/10.2147/HMER.S197933
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