Author/Authors :
Nassiri Toosi, M Department of Gastroentrology and Hepatology - Imam Khomeini Hospital - Tehran University of Medical Sciences,Tehran , Ghanaati, H Department of Radiology - Medical Imaging Center - Imam Khomeini Hospital - Tehran University of Medical Sciences, Tehran , Azmoudeh Ardalan, F Department of Pathology - Imam Khomeini Hospital - Tehran University of Medical Sciences, Tehran , Agdarkosh, H Department of Gastroentrology and Hepatology - Imam Khomeini Hospital - Tehran University of Medical Sciences,Tehran , Safai, S. R Department of Hematology and Oncology - Vali-Asr Hospital - Tehran University of Medical Sciences, Tehran , Lak, M Imam Khomeini Hospital - Tehran University of Medical Sciences, Tehran , Managhchi, M Imam Khomeini Hospital - Tehran University of Medical Sciences, Tehran , Karimi, N Imam Khomeini Hospital - Tehran University of Medical Sciences, Tehran , Foroutan, H Department of Gastroentrology and Hepatology - Imam Khomeini Hospital - Tehran University of Medical Sciences,Tehran , Ghofrani, H Department of Gastroentrology and Hepatology - Imam Khomeini Hospital - Tehran University of Medical Sciences,Tehran , Farahvash, M Department of Gastroentrology and Hepatology - Imam Khomeini Hospital - Tehran University of Medical Sciences,Tehran , Alavian, S. M Department of Gastroentrology and Hepatology - Baghiyyatollah Hospital - Baghiyyatollah University of Medical Sciences, Tehran , Shirani, S Department of Hematology and Oncology - Vali-Asr Hospital - Tehran University of Medical Sciences, Tehran , Saberi, H Imam Khomeini Hospital - Tehran University of Medical Sciences, Tehran
Abstract :
Background/Objectives: Liver biopsy in patients with congenital bleeding disorders (CBD)
andhepatitisC virus(HCV)infectionisstilla challengebetweenriskofprocedureandeffect
ofbiopsyresultonmanagement.
MaterialsandMethods:Wedidtransjugularliverbiopsy(TJLB)on12patientswithCBDwith
chronic HCV infection and elevated liver enzymes to determine its safety, efficiency and
therapeuticconsequences.
Results: All patients were men, with a median age of 29.5 years (14–54 years). Eleven
patients had haemophilia A (10 severe, one moderate) and one patient had factor XIII
deficiency, with no titer of inhibitor. HCV genotyping was carried out with type 1a (7
patients),type1b(2patients),type3 (2patients)andgenotype1aand1b(1patient).HIVand
HBVco-infectionwasnegativeinallpatients.WeusedthemodifiedRossneedlewith100%
transjugularaccessratetothehepaticveinsand92%successrate in tissueobtaining.The
specimenobtainedwassatisfactorybut limited for histopathologic diagnosis in54.5%.Mild
hepatitiswas revealed in4 patients (36.4%),moderatehepatitis in5 (45.4%)andextended
fibrosis or cirrhosis in2 (18.2%).Therewere2 procedure-related complications (16.6%).The
majorlimitationoftechniquewaslownumberofportalareainliverbiopsies.
Conclusion:TJLBwithsomelimitationsisusefulinpatientswithCBD.Transjugularapproach
to liver biopsy isa safeandeffectivealternativetothepercutaneousapproachinpatients
with CBD and could be requested to determine their liver prognosis and considered for
diagnosticliverbiopsypriortoanti-HCVtherapy.
Keywords :
congenital bleeding disorder , liver , biopsy , hepatitis
