Cirrhosis other diagnostic studies
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Editor-In-Chief: C. Michael Gibson, M.S., M.D. [1] Associate Editor(s)-in-Chief:
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Overview
The gold standard diagnostic test for cirrhosis is liver biopsy, although it is rarely necessary for diagnosis or treatment. NT-proBNP can be used to evaluate the complications of cirrhosis.
Other Diagnostic Studies
Liver Biopsy
The gold standard for diagnosis of cirrhosis is a liver biopsy, through a percutaneous, transjugular, laparoscopic, or fine-needle approach. Histologically, cirrhosis can be classified as micronodular, macronodular, or mixed, but this classification has been abandoned since it is nonspecific to the etiology. It may change as the disease progresses, and serological markers are much more specific, however, a biopsy is not necessary if the clinical, laboratory, and radiologic data suggests cirrhosis. Furthermore, there is a small but significant risk to liver biopsy, and cirrhosis itself predisposes for complications due to liver biopsy.[1]
- Alcoholic liver disease : Liver biopsy may show hepatocyte necrosis, Mallory bodies, and neutrophilic infiltration with perivenular inflammation.
- Primary biliary cirrhosis : Gold standard diagnosis is antimitochondrial antibodies with liver biopsy as confirmation if showing florid bile duct lesions.
NT-proBNP (N Terminal pro Brain Natriuretic Peptide)
- N Terminal pro Brain Natriuretic peptide is an important factor for evaluating the complications of cirrhosis.[2]
- High levels of NT-proBNP ( >101 pg/ml) is the marker of esophageal varices.
- NT-proBNP is not a marker of cirrhosis progression.
References
- ↑ Grant, A (1999). "Guidelines on the use of liver biopsy in clinical practice". Gut. 45 (Suppl 4): 1–11. PMID 10485854.
The main cause of mortality after percutaneous liver biopsy is intraperitoneal haemorrhage as shown in a retrospective Italian study of 68,000 percutaneous liver biopsies in which all six patients who died did so from intraperitoneal haemorrhage. Three of these patients had had a laparotomy, and all had either cirrhosis or malignant disease, both of which are risk factors for bleeding.
Unknown parameter|coauthors=ignored (help) - ↑ Ljubicic N, Gomercic M, Zekanovic D, Bodrozic-Dzakic T, Djuzel A (2012). "New insight into the role of NT-proBNP in alcoholic liver cirrhosis as a noninvasive marker of esophageal varices". Croatian Medical Journal. 53 (4): 374–8. PMC 3428825. PMID 22911531. Retrieved 2012-09-06. Unknown parameter
|month=ignored (help)