Rey, Johannes Wilhelm and Jahn-Eimermacher, Antje and Doernberger, Veronika and Barreiros, Ana Paula and Krupp, Markus and Hoffman, Arthur and Kiesslich, Ralf and Mueller-Schilling, Martina and Galle, Peter Robert and Teufel, Andreas (2014) To Biopsy or Not to Biopsy: Evaluation of a Large German Cohort of Patients with Abnormal Liver Tests of Unknown Etiology. DIGESTION, 89 (4). pp. 310-318. ISSN 0012-2823, 1421-9867
Full text not available from this repository. (Request a copy)Abstract
Background and Aims: Despite increasingly sensitive and accurate blood tests to detect liver disease, liver biopsy remains very useful in patients with atypical clinical features and abnormal liver tests of unknown etiology. The aim was to determine those elevated laboratory liver parameters that cause the clinician to order a biopsy, and whether laboratory tests are associated with pathological findings on histology. Methods: 504 patients with unclear hepatopathy, admitted to the outpatient clinic of a university hospital between 2007 and 2010, were analyzed with respect to laboratory results, clinical data, and the results of liver biopsies. Results: Aspartate aminotransferase (AST) and glutamate dehydrogenase (GLDH) levels above the normal range significantly increased the likelihood of recommending a liver biopsy by 81% [OR with 95% CI 1.81 (1.21-2.71), p = 0.004] and 159% [OR with 95% CI 2.59 (1.70-3.93), p < 0.001], respectively. AST values above normal were associated with fibrosis (63 vs. 40% for normal AST, p = 0.010). Elevated ferritin levels pointed to a higher incidence of steatosis (48 vs. 10% for normal ferritin, p < 0.001) and inflammation (87 vs. 62% for normal ferritin, p = 0.004). Conclusions: Our results indicate that elevated AST and GLDH were associated with a greater likelihood of recommending liver biopsy. Elevated AST and ferritin levels were associated with steatosis, inflammation and fibrosis on liver biopsies. Thus, AST and ferritin may be useful non-invasive predictors of liver pathology in patients with unclear hepatopathy. (C) 2014 S. Karger AG, Basel
| Item Type: | Article |
|---|---|
| Uncontrolled Keywords: | SERUM AMINOTRANSFERASE ACTIVITY; ALANINE-AMINOTRANSFERASE; ASYMPTOMATIC PATIENTS; UNITED-STATES; ASPARTATE-AMINOTRANSFERASE; ANOREXIA-NERVOSA; BLOOD-DONORS; DISEASE; PREVALENCE; ELEVATION; Liver chemistry test; Aminotransferases; Glutamate dehydrogenase; Aspartate aminotransferase; Ferritin; Unclear hepatopathy; Non-alcoholic fatty liver disease; Liver biopsy |
| Subjects: | 600 Technology > 610 Medical sciences Medicine |
| Divisions: | Medicine > Lehrstuhl für Innere Medizin I |
| Depositing User: | Dr. Gernot Deinzer |
| Date Deposited: | 29 Nov 2019 09:15 |
| Last Modified: | 29 Nov 2019 09:15 |
| URI: | https://pred.uni-regensburg.de/id/eprint/10954 |
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