AI Article Synopsis

  • The study aimed to evaluate the importance of liver biopsy in patients with unexplained elevated transaminases, following current clinical guidelines.
  • A retrospective analysis of 87 patients revealed that 48% had minimal or normal liver tissue changes, while different injury patterns were identified in varying percentages: steatosis (21%), hepatitis (13%), vascular (8%), and biliary (1%).
  • Ultimately, liver biopsy significantly impacted clinical management in 15% of cases, helping diagnose conditions like autoimmune hepatitis and metabolic dysfunction, but most patients showed little to no significant pathology.

Article Abstract

Background & Aims: Liver biopsy contribution in patients with unexplained elevation of transaminases is not clearly established. The aim was to study liver biopsy contribution in patients with unexplained elevated transaminases strictly defined according to the current guidelines, reflecting the present clinical practice.

Methods: In a retrospective study, we identified all the liver biopsies performed in patients with elevated transaminases for at least six months. Patients with a particular context, or with an identified cause of liver disease were excluded. The biopsies were classified according to the 4 following injury patterns: hepatitic, biliary, steatotic, vascular.

Results: 87 patients were included. Liver biopsy showed minimal changes or a normal histology in 48%, a steatotic pattern in 21%, a hepatitic pattern in 13%, a vascular pattern in 8%, a biliary pattern in 1%, and a mixed pattern in 8%. A cause could be determined in 21% of patients with normal histology, 85% with steatosis, 56% with hepatitis, 75% with biliary, but in none with isolated vascular pattern. Liver biopsy had important clinical and therapeutic implications in 15% of patients, with a diagnosis of autoimmune hepatitis, primary biliary cholangitis or metabolic dysfunction-associated steatohepatitis. Elevation of transaminases > 10 upper normal limit was present in all the patients with confirmed autoimmune hepatitis, but in only 7% of others.

Conclusion: Liver biopsy had important clinical and therapeutic implications in 15% of patients. However, the majority of patients had minimal changes without a cause, or minor vascular lesions of uncertain significance.

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Source
http://dx.doi.org/10.1007/s10620-024-08730-0DOI Listing

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