Hepatic Fatty Metamorphosis

My first wife Priscilla was a hard drinker. It trashed our first marriage after two attempts at rehab – she just couldn’t give it up. Brilliant woman, Radcliffe cum laude English scholar. I can still remember how she would sit reading or writing in an endless journal, smoking and drinking beer after beer with occasional breaks for hits on a fifth of gin. She ate little and when we parted she was under 110 lbs and losing steadily.

I haven’t heard from her in years and if this is how she may meet her end I hope she’s found help. It sounds horriffic all around.

This text is a direct transcription from this PDF:

Alcohol-Related Sudden Death with Hepatic Fatty Metamorphosis: A Comprehensive Clinicopathological Inquiry into its Pathogenesis

Abstract – To clarify the pathogenesis of the widely-known but obscure symptom of sudden death with hepatic fatty metamorphosis observed in alcohol abusers, we have scrutinized both the clinical and pathological data of 11 subjects who died under such circumstances between 1987 and 1993. Death followed several days of uninterrupted drinking often with little dietary intake. The notable clinical features on arrival at the emergency room were disturbance of consciousness (11/11), hypotension (4/6), hypothermia (3/5), hypoglycemia (8/11), metabolic acidosis (6/6), renal dysfunction (11/11), and hyperammonaemia (5/5). The common hepatic pathology was the extensive appearance of numerous microvesicular fatty droplets in the hepatocytes together with varying degrees of macrovesicular fatty change; four subjects had an underlying cirrhosis. Death undoubtedly results from a variety of metabolic disturbances triggered by the combination of massive ethanol intake and starvation. The appearance of extensive microvesicular fatty change superimposed on macrovesicular fatty change was considered to be an associated phenomenon.


It’s also referred to as liver fatty metamorphosis.

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