Volume 77, Number 8
Noninvasive tests for liver disease, fibrosis, and cirrhosis:
Is liver biopsy obsolete?
1. For which patient could blood tests and imaging most reliably replace liver biopsy to establish a diagnosis?
- A 40-year-old woman with a history of ulcerative colitis who presents with fatigue and itching and is found to have elevated serum alkaline phosphatase and bilirubin levels
- A 55-year-old obese man who you think may have cirrhosis, and in whom computed tomography shows a fatty liver
- A 60-year-old woman who presents with an enlarged liver, easy bruising, an enlarged tongue, edema, and lymphadenopathy
- A 45-year-old man who received a liver transplant because of primary biliary cirrhosis several years ago who has newly elevated liver enzyme levels
