title: [Clinical usefulness and diagnostic value of percutaneous liver biopsy in patients with chronically elevated liver enzymes of non-viral origin].
abstract: BACKGROUND
  In the context of increasing non-invasive diagnostic techniques the purpose of the present study was to determine the clinical usefulness and the diagnostic value of percutaneous liver biopsy in patients with chronically elevated liver enzymes of non-viral origin.
  
  
  METHODS
  100 patients from the outpatient clinic of the department of gastroenterology and hepatology who had a liver biopsy in the years 1996 to 1998 because of chronically elevated alanine-aminotransferase (ALT) and/or gamma-glutamyltransferase (gamma-GT) levels were included. Exclusion criteria were as follows: chronic hepatitis B or C infection, focal liver disease and clinical signs of hepatic decompensation. Retrospectively gained clinical data were independently evaluated by two experienced hepatologists. Initially, both examiners made a preliminary clinical diagnosis prior to knowing results from liver histology. With the results from liver histology both examiners were asked to make a final diagnosis. For each patient, the preliminary clinical diagnoses of both examiners were then correlated with the corresponding final diagnoses.
  
  
  RESULTS
  Liver histology led in 71 % respectively 74 % of the patients to confirmation or specification of the clinical diagnosis. Liver biopsy was particularly helpful in differentiating non-decompensated liver cirrhosis, cryptogenic hepatitis, auto-immune hepatitis and biliary diseases.
  
  
  CONCLUSIONS
  Despite improved non-invasive diagnostic tools including a broad spectrum of serologic tests liver biopsy is often indispensable for differentiating primary liver from biliary diseases and for the early detection of patients with liver cirrhosis.
authors.affiliation: Abteilung für Gastroenterologie, Infektionskrankheiten und Vergiftungen, Medizinische Klinik IV, Universitätsklinikum Heidelberg. Lukas_Schwake@gmx.net
authors.forename: L
authors.initials: L
authors.lastname: Schwake
authors.forename: U
authors.initials: U
authors.lastname: Müller
authors.forename: L
authors.initials: L
authors.lastname: Theilmann
authors.forename: A
authors.initials: A
authors.lastname: von Herbay
authors.forename: W J
authors.initials: WJ
authors.lastname: Hofmann
authors.forename: W
authors.initials: W
authors.lastname: Stremmel
authors.forename: B
authors.initials: B
authors.lastname: Kallinowski
mesh_terms: D000328:Adult; D000368:Aged; D000410:Alanine Transaminase / Q000097:blood*; D001706:Biopsy; D002908:Chronic Disease; D003937:Diagnosis, Differential; D005260:Female; D006801:Humans; D008099:Liver / Q000473:pathology; D008107:Liver Diseases / Q000473:pathology*; D008111:Liver Function Tests; D008297:Male; D008875:Middle Aged; D015588:Observer Variation; D012680:Sensitivity and Specificity; D005723:gamma-Glutamyltransferase / Q000097:blood*
chemical_list: D005723:gamma-Glutamyltransferase; D000410:Alanine Transaminase
vernacular_title: Klinischer Nutzen und diagnostische Bedeutung der Leberbiopsie bei chronisch erhöhten Leberwerten nicht viraler Genese.