Clinical Pearl

Use the Lille Score at day 7 of cortiosteroid treatment for severe alcoholic hepatitis to determine whether the treatment is working (and whether to continue steroids).  Don’t have a calculator?  Use the serum bilirubin as a surrogate marker; if it’s not falling by day 7, that likely means the Lille score will be high (>0.45) and steroids aren’t working.  In this case, additional steroids are unlikely to confer a survival benefit.

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