Natural course of subjects with elevated liver tests and normal liver histology.
- Strasser M First Department of Medicine, Paracelsus Medical University, Salzburg, Austria.
- Stadlmayr A Department of Internal Medicine, Oberndorf Hospital, Oberndorf, Austria.
- Haufe H Department of Pathology, Paracelsus Medical University, Salzburg, Austria.
- Stickel F Hepatology Unit, Clinic Beau-Site, Bern and Department of Gastroenterology and Hepatology, University Hospital Zurich, Zurich, Switzerland.
- Ferenci P Third Department of Medicine, Gastroenterology and Hepatology, Medical University Vienna, Vienna, Austria.
- Patsch W Department of Pharmacology and Toxicology, Paracelsus Medical University, Salzburg, Austria.
- Feldman A First Department of Medicine, Paracelsus Medical University, Salzburg, Austria.
- Weghuber D Obesity Research Unit, Paracelsus Medical University, Salzburg, Austria.
- Datz C Department of Internal Medicine, Oberndorf Hospital, Oberndorf, Austria.
- Aigner E First Department of Medicine, Paracelsus Medical University, Salzburg, Austria.
- 2015-08-11
Published in:
- Liver international : official journal of the International Association for the Study of the Liver. - 2016
NAFLD
autoimmune hepatitis
liver
liver biopsy
normal histology
Adult
Alcohol Drinking
Austria
Female
Follow-Up Studies
Hepatitis, Autoimmune
Humans
Liver
Liver Diseases
Liver Diseases, Alcoholic
Liver Function Tests
Male
Middle Aged
Risk Factors
Weight Gain
English
BACKGROUND & AIMS
Liver biopsy (LB) is performed if non-invasive work-up of liver disease is inconclusive. The examination of liver tissue occasionally reveals normal histology. Long-term follow-up of such patients has not been performed.
METHODS
We identified a total 70 subjects from our LB database with elevated liver tests and normal liver histology after a mean of 90.5 ± 52.3 (range 15-216) months and conducted reassessment of medical history, physical examination, laboratory testing, ultrasound, transient elastography and LB if indicated.
RESULTS
At follow-up examination, 15 (7 females (f)/8 males (m); 21.4%) subjects had normal liver tests and no further evidence of liver disease. A subset of 37 (29 f/8 m; 52.9%) subjects had persistently elevated liver tests without evidence indicating progressive liver disease but the cause thereof remained unexplained also at the follow-up visit. Three (0 f/3 m; 4.3%) subjects had consumed excessive alcohol with indicators of alcoholic liver disease. Eleven subjects (4 f/7 m; 15.7%) had developed steatosis on ultrasound examination along with weight gain and/or biochemical features of the metabolic syndrome. In addition, three (2 f/1 m) patients developed autoimmune hepatitis, one female presented with primary biliary cirrhosis. One male was diagnosed with cholangiocellular carcinoma 3 months after the initial evaluation.
CONCLUSION
The clinical course of most patients was benign, but in approximately 20% of the subjects a liver disease developed. Particular attention should be given to autoimmune liver diseases in subjects with positive autoantibodies. In addition, lifestyle factors such as weight gain and alcohol consumption were associated with the manifestation of liver diseases.
Liver biopsy (LB) is performed if non-invasive work-up of liver disease is inconclusive. The examination of liver tissue occasionally reveals normal histology. Long-term follow-up of such patients has not been performed.
METHODS
We identified a total 70 subjects from our LB database with elevated liver tests and normal liver histology after a mean of 90.5 ± 52.3 (range 15-216) months and conducted reassessment of medical history, physical examination, laboratory testing, ultrasound, transient elastography and LB if indicated.
RESULTS
At follow-up examination, 15 (7 females (f)/8 males (m); 21.4%) subjects had normal liver tests and no further evidence of liver disease. A subset of 37 (29 f/8 m; 52.9%) subjects had persistently elevated liver tests without evidence indicating progressive liver disease but the cause thereof remained unexplained also at the follow-up visit. Three (0 f/3 m; 4.3%) subjects had consumed excessive alcohol with indicators of alcoholic liver disease. Eleven subjects (4 f/7 m; 15.7%) had developed steatosis on ultrasound examination along with weight gain and/or biochemical features of the metabolic syndrome. In addition, three (2 f/1 m) patients developed autoimmune hepatitis, one female presented with primary biliary cirrhosis. One male was diagnosed with cholangiocellular carcinoma 3 months after the initial evaluation.
CONCLUSION
The clinical course of most patients was benign, but in approximately 20% of the subjects a liver disease developed. Particular attention should be given to autoimmune liver diseases in subjects with positive autoantibodies. In addition, lifestyle factors such as weight gain and alcohol consumption were associated with the manifestation of liver diseases.
- Language
-
- English
- Open access status
- green
- Identifiers
-
- DOI 10.1111/liv.12935
- PMID 26256590
- Persistent URL
- https://folia.unifr.ch/global/documents/244928
Statistics
Document views: 15
File downloads:
- fulltext.pdf: 0