title: Acute sickle cell hepatopathy represents a potential contraindication for percutaneous liver biopsy.
abstract: After several complications following percutaneous liver biopsy in patients with sickle cell disease, we reviewed our experience. We examined 14 patients with sickle cell disease who underwent a percutaneous liver biopsy. Clinicopathologic findings were correlated with outcome. Of 14 patients, 5 (36%) suffered serious hemorrhage; 4 died (80%; 28% of all patients). None of the 9 patients without biopsy complications was in an acute sickling crisis at the time of biopsy; 4 of 5 patients with complications were in acute sickling crisis. Of the 5 patients with complications, 4 underwent biopsy for an emergency indication. Chronic venous outflow obstruction, marked hepatic sequestration of erythrocytes, and sinusoidal dilatation were strongly associated with complications. Data obtained by biopsy in group 1 were not of substantial value in clinical management, in contrast to group 2 (8/9; 89%). Acute hepatic disease complicating sickle cell anemia represents a newly identified contraindication to percutaneous liver biopsy.
authors.affiliation: Institute of Liver Studies and the Department of Haematological Medicine, King's College Hospital, London, United Kingdom. nadawho@hotmail.com
authors.forename: Nada
authors.initials: N
authors.lastname: Zakaria
authors.forename: Alex
authors.initials: A
authors.lastname: Knisely
authors.forename: Bernard
authors.initials: B
authors.lastname: Portmann
authors.forename: Giorgina
authors.initials: G
authors.lastname: Mieli-Vergani
authors.forename: Julia
authors.initials: J
authors.lastname: Wendon
authors.forename: Roopen
authors.initials: R
authors.lastname: Arya
authors.forename: John
authors.initials: J
authors.lastname: Devlin
mesh_terms: D000208:Acute Disease; D000293:Adolescent; D000328:Adult; D000755:Anemia, Sickle Cell / Q000150:complications* / Q000473:pathology; D001706:Biopsy / Q000009:adverse effects / Q000401:mortality; D002648:Child; D000075202:Contraindications; D005260:Female; D006470:Hemorrhage / Q000209:etiology; D006801:Humans; D008099:Liver / Q000473:pathology*; D008107:Liver Diseases / Q000209:etiology / Q000473:pathology; D008297:Male; D008875:Middle Aged; D012189:Retrospective Studies; D018570:Risk Assessment