Alcoholic liver disease other diagnostic studies

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Editor-In-Chief: C. Michael Gibson, M.S., M.D. [1]; Associate Editor(s)-in-Chief: M. Khurram Afzal, MD [2]

Overview

Liver biopsy is used to confirm the diagnosis when alcoholic hepatitis is suspected, and to help in guiding medical treatment. Microscopic findings on biopsy that indicate alcoholic hepatitis are: polymorphonuclear infiltration of cells, hepatic necrosis, ballooning hepatocytes, Mallory bodies within cells, and perivenular and perisinusoidal fibrosis.

Other Diagnostic Studies

Liver Biopsy

Other diagnostic tests

Biomarkers for assessing fibrosis in patients with alcoholic liver disease:[1]

  • FibroTest[2]
    • Based on α2-macroglobulin, haptoglobin, GGT, ApoA1 and bilirubin
  • FibrometerA[3]
    • Based on prothrombin time, α2-macroglobulin, hyaluronic acid and age
  • Hepascore[4]
    • Based on bilirubin, GGT, α2-macroglobulin, hyaluronic acid , age and gender

2010 AASLD/ACG Alcoholic Liver Disease Guidelines (DO NOT EDIT)[5]

Biopsy : Guidelines (DO NOT EDIT)[5]

Class I
1. " For patients with a clinical diagnosis of severe alcoholic hepatitis (AH) for whom medical treatment is contemplated, or for those in whom reasonable uncertainty exists regarding the underlying diagnosis, a liver biopsy should be considered. This decision will depend on local expertise and ability in performing a liver biopsy in patients with coagulopathy, the patient’s severity of illness, and the type of therapy under consideration (Level of evidence: C) "

References

  1. Mueller S, Seitz HK, Rausch V (2014). "Non-invasive diagnosis of alcoholic liver disease". World J. Gastroenterol. 20 (40): 14626–41. doi:10.3748/wjg.v20.i40.14626. PMC 4209529. PMID 25356026.
  2. Naveau S, Gaudé G, Asnacios A, Agostini H, Abella A, Barri-Ova N, Dauvois B, Prévot S, Ngo Y, Munteanu M, Balian A, Njiké-Nakseu M, Perlemuter G, Poynard T (2009). "Diagnostic and prognostic values of noninvasive biomarkers of fibrosis in patients with alcoholic liver disease". Hepatology. 49 (1): 97–105. doi:10.1002/hep.22576. PMID 19053048.
  3. Naveau S, Raynard B, Ratziu V, Abella A, Imbert-Bismut F, Messous D, Beuzen F, Capron F, Thabut D, Munteanu M, Chaput JC, Poynard T (2005). "Biomarkers for the prediction of liver fibrosis in patients with chronic alcoholic liver disease". Clin. Gastroenterol. Hepatol. 3 (2): 167–74. PMID 15704051.
  4. Calès P, Oberti F, Michalak S, Hubert-Fouchard I, Rousselet MC, Konaté A, Gallois Y, Ternisien C, Chevailler A, Lunel F (2005). "A novel panel of blood markers to assess the degree of liver fibrosis". Hepatology. 42 (6): 1373–81. doi:10.1002/hep.20935. PMID 16317693.
  5. 5.0 5.1 "www.aasld.org" (PDF). Retrieved 2012-10-27.

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