Guidelines on the use of liver biopsy in clinical practice

Grant, A. Kerr; Neuberger, James

doi:10.1136/gut.45.2008.iv1

Cited by 342 publications

(331 citation statements)

References 61 publications

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“…ALT is used as a screening and initial diagnostic marker for NAFLD in clinical settings [4,6] and as a biomarker of NAFLD and liver fat content in epidemiological studies in which the use of more accurate but invasive and/or expensive tests is unethical or not feasible.…”

Section: Introductionmentioning

confidence: 99%

A modified Mediterranean diet is associated with the greatest reduction in alanine aminotransferase levels in obese type 2 diabetes patients: results of a quasi-randomised controlled trial

et al. 2008

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Aim The aim of the study was to compare the effect of different dietary interventions on alanine aminotransferase (ALT) in obese patients with diabetes. Methods A post hoc analysis of an open label, parallel design, quasi-randomised (allocation by alternation), controlled trial, conducted in Israel. Obese patients with diabetes (n=259), treated in the community, were centrally allocated to one of three diets: (1) the 2003 recommended American Diabetes Association diet (ADA): 50-55% carbohydrate, 30% fat and 20% protein, n=85; (2) a low glycaemic index (LGI) diet: 50-55% LGI carbohydrate, 30% fat, 15-20% protein, n = 89; or (3) a modified Mediterranean diet (MMD): 35% LGI carbohydrate, 45% fat that was high in monounsaturated fat, 15-20% protein, n=85. ALT was measured at 6 and 12 months. Results ALT levels decreased in all arms; however, the MMD was associated with the lowest ALT levels at month 6 (n=201: ADA n=64, LGI n=73, MMD n=64) and month 12 of follow-up (n=179). At 12 months mean ALT levels were 19.8±1.4 U/l in the ADA diet arm (n=54), 18.0±1.5 U/l in the LGI diet arm (n=64) and 14.4±1.7 in the MMD arm (n=61, p<0.001). Evidence for an effect of diet on ALT levels persisted when controlling for post-randomisation changes in waist to hip ratio, BMI, homeostasis model assessment (HOMA) or triacylglycerol. Conclusions A Mediterranean diet may have a beneficial effect on liver steatosis in obese patients with diabetes. Results of trials assessing the effect of dietary composition on clinical outcomes should be awaited before a decisive conclusion can be reached. In addition to clinical outcomes, such studies should address the issue of primary prevention of steatosis in high-risk and healthy individuals.

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Section: Introductionmentioning

confidence: 99%

A modified Mediterranean diet is associated with the greatest reduction in alanine aminotransferase levels in obese type 2 diabetes patients: results of a quasi-randomised controlled trial

et al. 2008

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“…Распространенность AИГ в сочетании с ПБЦ составляет до 19% среди пациентов с АИГ и до 9% среди пациентов с ПБЦ [51]. Динамическое наблюдение с целью определения эффективности и воз-можности отмены проводимой терапии у данной катего-рии пациентов также предполагает проведение морфо-логического исследования гепатобиоптатов [54].…”

Section: показания к проведению биопсии печени у детейunclassified

“…В большинстве случаев диагноз основывается на данных клинико-лабораторного и моле-кулярно-генетического методов исследований [54]. Биопсия печени может быть методом выбора для под-тверждения диагноза в случае неоднозначной клиниче-ской картины и невозможности провести дорогостоящую ДНК-диагностику.…”

Section: показания к проведению биопсии печени у детейunclassified

Modern Possibilities of Endosurgical Biopsy in Children with Chronic Liver Diseases

et al. 2018

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“…There are widely divergent opinions about the values at which abnormal coagulation indexes become contraindications to PLB; however, in most US centers, an international normalized ratio (INR)41.5 and platelet count550 000/mm 3 appear to be a strong contraindication for the procedure [Grant and Neuberger, 1999]. Abdominal pain after a PLB could represent just a minor complication like a local small subcapsular hematoma of the liver, a more serious fluid collection (biloma, hematoma or abscess formation) or severe intraperitoneal hemorrhage.…”

Section: Implications For Clinical Carementioning

confidence: 99%

Acute pancreatitis secondary to hemobilia after percutaneous liver biopsy

Peña

Horn

Cross

2009

Therap Adv Gastroenterol

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Percutaneous liver biopsy (PLB) is a valuable diagnostic tool. Complication rates vary depending on the technique used, experience of the physician, number of passes, bleeding parameters and other factors. Hemorrhage is a common complication after PLB and can present as intraperitoneal bleeding, intrahepatic or subcapsular hematoma, or rarely as hemobilia. Acute pancreatitis is a rare complication of hemobilia. We describe a single case of acute pancreatitis caused by biliary obstruction due to hemobilia following PLB. The obstruction was successfully managed with biliary stent drainage.

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Guidelines on the use of liver biopsy in clinical practice

Cited by 342 publications

References 61 publications

A modified Mediterranean diet is associated with the greatest reduction in alanine aminotransferase levels in obese type 2 diabetes patients: results of a quasi-randomised controlled trial

A modified Mediterranean diet is associated with the greatest reduction in alanine aminotransferase levels in obese type 2 diabetes patients: results of a quasi-randomised controlled trial

Modern Possibilities of Endosurgical Biopsy in Children with Chronic Liver Diseases

Acute pancreatitis secondary to hemobilia after percutaneous liver biopsy

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