Are the advantages of obtaining a liver biopsy outweighed by the disadvantages?

Cobbold, Jeremy; Taylor‐Robinson, Simon D.

doi:10.1002/9781118924938.ch17

Cited by 1 publication

(1 citation statement)

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“…The invasiveness, associated risks, complications, and limitations of sampling have spurred the development of a number of non-invasive tests to assess liver dysfunction. Previous work has highlighted the pros and cons of the needle biopsy, with the current focus on improved imaging and the development of biomarkers to aid in diagnosis [ 1 ]. However, in this pursuit of devising “patient-friendly” non-invasive modalities, a lack of tissue diagnosis may be detrimental to patient care.…”

Section: Introductionmentioning

confidence: 99%

Chronic Liver Disease Presenting as Immune Hemolytic Anemia: The Challenges of Diagnosis in the Critically Ill in a Resource-Limited Health Care Setting

Gaur¹,

Puri²,

Agarwal³

et al. 2021

Cureus

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Immune hemolytic anemia is very rarely associated with chronic liver disease. Diagnosis is often complicated in critically ill patients, where an etiological diagnosis can be elusive, especially in routine health care settings. A 48-year-old man presented with jaundice for three months. Ultrasonography showed features of chronic liver disease. Fibroscan showed increased parenchymal stiffness suggesting cirrhosis. Investigations revealed immune hemolytic anemia and thrombocytopenia. A percutaneous liver biopsy was not performed due to worsening thrombocytopenia. Isolated protein C deficiency and portal vein thrombosis were noted in subsequent testing. The patient eventually succumbed to illness. Coagulopathy such as protein C and D-dimer elevation discovered in subsequent rounds of testing may be misleading in rapidly deteriorating patients, emphasizing the need for timely coagulation workup and imaging. Despite comprehensive testing, lack of liver biopsy, as seen herein, may hamper clinical management. Training residents in the skill of transjugular liver biopsy is necessary to manage critical patients at secondary health care facilities.

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Section: Introductionmentioning

confidence: 99%