• Active alcoholic hepatitis with jaundice to assess severity
• Determine eligibility for corticosteroid therapy
• Identify patients requiring ICU-level monitoring
• Prognosticate 30-day mortality in active drinkers presenting with liver failure

• DF < 32: Non-severe AH. Supportive management. No steroids.
• DF ≥ 32: Severe AH. 30-day mortality 35–45%. Consider prednisolone 40mg/day × 28 days if no contraindications.

• After 7 days of prednisolone, calculate the Lille Model score
• Lille score < 0.45: Steroid responder — complete 28-day course
• Lille score ≥ 0.45: Non-responder — discontinue steroids (no benefit, continued infection risk)

• Active GI bleeding
• Active untreated bacterial infection (treat infection first, then reassess)
• Renal failure (creatinine > 2.5 mg/dL — consider pentoxifylline)
• Uncontrolled hepatic encephalopathy or coma
• HBV or HCV co-infection (risk viral reactivation)

• Prednisolone 40mg orally daily × 28 days (preferred over methylprednisolone)
• Nutritional support: EN via NGT if oral intake inadequate (target 35–40 kcal/kg/day, 1.2–1.5g protein/kg/day)
• Thiamine 300mg IV daily × 3 days, then oral B-vitamins
• Lille Model on Day 7: if ≥ 0.45, stop steroids
• Prophylactic PPI for GI bleeding risk
• Transplant evaluation in selected non-responders

A hepatologist who published the discriminant function in 1978 as part of the first RCT of corticosteroids in alcoholic hepatitis. His formula — combining PT prolongation with bilirubin — elegantly captured both synthetic dysfunction and cholestasis in a single score, remaining the entry criterion for steroid trials in AH for over 45 years.