Acute Alcoholic Hepatitis in Singapore: A Comparison with Western Series*

Summary: In a prospective clinicopathological study, 50 cases of acute alcoholic hepatitis were found in a three year period, in Singapore. This Singapore series was compared to two western series and the results were analysed statistically. The results showed the following significant differences. Clinical jaundice, hepatic coma and deaths were significantly more frequent in the Singapore series than the western ones. A significantly higher incidence of hypokalaemia was probably responsible for the higher incidence of hepatic coma in the Singapore series. Macrocytic anaemia was the commonest type of anaemia in the western series but was not found in the Singapore series, in which hypochromic anaemia was the commonest. The SG PT level was more frequently raised in Singapore patients than the western ones. However, serum transaminase levels were normal in some cases of acute alcoholic hepatitis in both Singapore and western series. It is concluded that serum transaminase levels are not reliable in the diagnosis of acute alcoholic hepatitis. A liver biopsy is essential for a firm diagnosis. In the liver histology, the incidence of cirrhosis in the Singapore series was significantly higher than that of one of the western series, but lower than that of the other. The incidence of Mallory's hyaline in the Singapore series was lower than the western series because it was not essential for diagnosis in the Singapore patients. Besides these few differences, acute alcoholic hepatitis was fairly similar in Singapore and western countries.