Findings on liver biopsy to investigate abnormal liver function tests in the absence of diagnostic serology

Background/Aims: The significance of abnormal liver function tests in the a bsence of diagnostic serology is unclear. The aim of this study was to repo rt liver biopsy findings in a large group of patients with unexplained abno rmal liver biochemistry. Methods: Histological findings were examined in 354 patients who underwent liver biopsy to investigate abnormal liver function tests. Results: Six percent of patients had a normal liver biopsy while 26% were f ound to have some degree of fibrosis and 6% were cirrhotic. Thirty four and 32% of biopsies suggested non-alcoholic steatohepatits or fatty liver resp ectively. Other diagnoses included cryptogenic hepatitis, drug toxicity, pr imary and secondary biliary cirrhosis, autoimmune hepatits, alcohol-related liver disease, primary sclerosing cholangitis, haemochromatosis, amyloid a nd glycogen storage disease. Patient management was directly altered in 18% of patients due to liver biopsy findings and three families were entered i nto screening programmes for inheritable liver disease. Conclusions: The finding of abnormal liver function tests in the absence of diagnostic serology may indicate significant liver disease. Liver biopsy y ields a range of liver diseases of diverse nature and extent. Liver disease s may be uncovered for which specific treatment is indicated. (C) 2001 Euro pean Association for the Study of the Liver. Published by Elsevier Science B.V. All rights reserved.