This study is designed to evaluate the hypothesis that patients with severe acute alcoholic hepatitis have lower morbi-mortality if the patients receive treatment with corticosteroids + NAC, compared to patients that only receive corticosteroids.
Men and women.
Age from 18 to 75 years.
Patients with acute alcoholic hepatitis according to AASLD criteria or compatible liver histology.
Maddrey score> = 32.
Any cause of jaundice: acute hepatitis, positive HIV serology, biliary-pancreatic pathology, hemolytic anemia.
Allergy or intolerance to N-acetylcysteine and / or corticosteroids.
Hepatocarcinoma.
Portal cavernomatosis.
Parallel
N-acetylcysteine
DrugDay 1: 150 mg/kg in 250ml 5% glucose over 30min + 50mgr/kg in 500ml glucose over 4h + 100mgr/kg in 1000ml glucose over 16h intravenously. Day 2-14: 100mgr/kg in 1000 ml glucose/24h intravenously. Day 15 until end of corticosteroid treatment: NAC 600mg orally every 24h.
Number of Participants with all-cause mortality at 6 months.
Main result variable.
Number of participants with complications: infections, ascites, gastrointestinal bleeding, renal failure, hepatic encephalopathy, need for MARSH or orthotopic liver transplantation.
Security variable.
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