Blood, 1 January 2003, Vol. 101, No. 1, pp. 101-103
CLINICAL OBSERVATIONS, INTERVENTIONS, AND THERAPEUTIC TRIALS
Brief report
Acute sickle cell hepatopathy represents a potential
contraindication for percutaneous liver biopsy
Nada Zakaria,
Alex Knisely,
Bernard Portmann,
Giorgina Mieli-Vergani,
Julia Wendon,
Roopen Arya, and
John Devlin
From the Institute of Liver Studies and the Department
of Haematological Medicine, King's College Hospital, London,
United Kingdom.
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.
