scholarly journals Clinicohistological correlation of etiological spectrum of chronic liver disease diagnosed during noncirrhotic stages in children: Can need of liver biopsy be obviated?

JGH Open ◽  
2020 ◽  
Author(s):  
Tryambak Samanta ◽  
Rajarshi Basu ◽  
Radheshyam Purkait ◽  
Sudipta Kar ◽  
Debasis Das ◽  
...  
2002 ◽  
Vol 16 (10) ◽  
pp. 722-726 ◽  
Author(s):  
Jacqueline Laurin

Most cases of nonalcoholic fatty liver disease (NAFLD) and nonalcoholic steatohepatitis (NASH) are suspected on the basis of the exclusion of viral, autoimmune, metabolic and genetic causes of chronic liver disease in patients with chronic elevation of aminotransferase enzymes. However, the definitive diagnosis of NASH requires liver biopsy. Valuable blood tests include hepatitis B and C serology, iron profile, alpha 1-antitrypsin phenotype, ceruloplasmin, antinuclear antibody and antismooth muscle antibody, and serum protein electrophoresis. If these tests are negative or normal, and if there are no symptoms or signs of chronic liver disease, it is unlikely that a specifically treatable liver disease would be discovered at biopsy. The prevalence of NAFLD in the general population appears to be approximately 20%, and 2% to 3% of people have NASH. There is no proven specific therapy for the spectrum of nonalcoholic liver disease; therefore, the management of the patient with NASH is not likely to be changed after histological assessment. Bleeding, sometimes fatal, and other complications requiring hospitalization can occur, and liver biopsies should not be undertaken without clear clinical indications. The high cost of undertaking histological assessment of all persons with asymptomatic elevations of liver enzymes cannot be justified in view of the risks and limited clinical benefits.


2020 ◽  
Vol 45 (11) ◽  
pp. 3463-3472
Author(s):  
Cheng Fang ◽  
Paul S. Sidhu

Abstract Chronic liver disease affects 185 million population worldwide. It encompasses a heterogenous disease spectrum, but all can lead to the development of liver fibrosis. The degree of liver fibrosis is not only a prognosticator, but has also been used to guide the treatment strategy and to evaluate treatment response. Traditionally, staging of liver fibrosis is determined on histological analysis using samples obtained from an invasive liver biopsy. Ultrasound-based liver elastography is a non-invasive method of assessing diffuse liver disease in patients with known chronic liver disease. The use of liver elastography has led to a significant reduction in the number of liver biopsies performed to assess the severity of liver fibrosis and a liver biopsy is now reserved for only select sub-groups of patients. The aim of this review article is to discuss the key findings and current evidence for ultrasound-based elastography in diffuse liver disease as well as the technical challenges and to evaluate the potential research direction.


2020 ◽  
Vol 115 (1) ◽  
pp. S1704-S1705
Author(s):  
Aws Alameri ◽  
Tamneet Singh ◽  
Ahmed Oglah ◽  
Mahnoor Mir ◽  
Joel Michalek ◽  
...  

2019 ◽  
Vol 19 (3) ◽  
pp. 2806-2311
Author(s):  
Süleyman Sönmez ◽  
Merve Boşat ◽  
Nihal Yurtseven ◽  
Eray Yurtseven

Background: Conventional ultrasonography is a method preferred for the investigation of chronic liver diseases in pediatric groups, as it is non-invasive, cheap, feasible and available. The purpose of this study is to present the role of Share-wave Elastography (SWE) in terms of diagnostic value in children diagnosed with “chronic liver disease.”Methods: We studied patients who had been diagnosed with chronic liver disease between March 2012-September 2015, and who had undergone liver biopsy and had their pathology results, compared with 26 healthy subjects. Statistical analysis was performed with IBM SPSS Statistics for Windows, Version 20.0. “Pearson Correlation Analysis” was performed in order to measure the relationship between elastography values and Brunt level.Results: This study had 107 subjects in total, consisting of 81 patients between 0-204 months of age Pearson correlation coefficient level was determined as r = 0.644. Since the correlation coefficient is positive, there is a same-directional relationship between Elastography level and Brunt degree. This means that while one of the variables is increasing, the other one will also increase.Conclusion: Since it is known that development of hepatic fibrosis is a dynamic process, and that many hepatic fibrosis etiologies are known to continue throughout the course of life, the application of Real time SWE method instead of repeated liver biopsies on patients is a much simpler and smart method. Increasing the clinical use of Real Time SWE method with future studies might provide an opportunity for preventing unnecessary liver biopsies since the patients are evaluated in a shorter time and in a cost-effective manner.Keywords: Shear-Wave Elastography, Brunt degree, chronic liver disease, liver biopsy.


Gut ◽  
1977 ◽  
Vol 18 (6) ◽  
pp. 472-475 ◽  
Author(s):  
J Sanchez-Tapias ◽  
H C Thomas ◽  
S Sherlock

2015 ◽  
Vol 22 (2) ◽  
pp. 120-124
Author(s):  
Mohammad Murad Hossain ◽  
Md Abul Kashem Khandaker ◽  
Khan Abul Kalam Azad ◽  
Md Hafiz Sardar ◽  
Shudip Ranjan Deb ◽  
...  

Background: The liver biopsy is considered by many experts to be the most specific diagnostic tool used to assess the nature and severity of liver diseases such as hepatitis C. Liver biopsies are important for many reasons, such as accurate diagnosis or ruling out any coexisting liver diseases, staging and grading the severity of liver disease, treatment decisions, patient and provider reassurance, and as a benchmark for gauging future progression. Methods: In this observational study, 50 patients were recruited from different Medicine units of Dhaka Medical College Hospital, Dhaka, from May, 2008 to June, 2009. After preliminary selection of patients, a specific protocol was followed which include patients’ particulars, clinical features and clinical diagnosis, biochemical parameters, radiological and other investigative procedures and finally percutaneous needle biopsy of liver was done. The objective of the study was to establish the correlation of clinical presentation of chronic parenchymal liver disease with histopathological findings and establish liver biopsy as a tool for diagnosis. SPSS version 16.0 was used to analyze the data. Quantitative data were presented in the form of tables and figures. Chi-square test and student t test was done to find out the statistical significance. Results: Histopathologically chronic liver disease (CLD) was found to be the commonest lesion (pd”0.05), which was 24 (48%) followed by hepatocellular carcinoma 13(26%) and secondary deposit 02(4%). Eleven cases consist of other findings including normal. CLD commonly presented with loss of appetite (82%), Jaundice (74%), Weight loss (68%), hepatic facies (54%).Hepatocellular carcinoma commonly presented with hepatomegaly (100%), jaundice (61.84%), weight loss (76.92%), and ascites (53.85%). Hepatomegaly was constant feature (100%) of all secondary metastasis. Among two cases of secondary carcinoma one (50%) was adenocarcinoma and another one (50%) was anaplastic type. Out of 29 cases of clinically diagnosed chronic liver disease 24 cases were confirmed histopathologically which was statistically significant (pd”0.05). Conclusion: For the establishment of diagnosis and treatment it is mandatory to have a good correlation between clinical features and histopathological finding. Histopathology could detect diseases which were not considered clinically and specific management could only be done depending on histopathology. Therefore, if there is no contraindication, for confirmation of diagnosis liver biopsy still remains the corner stone modality. DOI: http://dx.doi.org/10.3329/jdmc.v22i2.21520 J Dhaka Medical College, Vol. 22, No.2, October, 2013, Page 120-124


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