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Prepublished online as a Blood First Edition Paper on August 15, 2002; DOI 10.1182/blood-2002-06-1823.
Submitted June 26, 2002
Accepted August 7, 2002
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
Institute of Liver Studies, King's College Hospital, London, United Kingdom
* Corresponding author; email: nadawho{at}hotmail.com.
Background: After several complications following percutaneous liver biopsy in patients with sickle cell disease, we reviewed our experience. Patients and Methods: 14 patients with sickle cell disease who underwent a percutaneous liver biopsy. Clinicopathological findings were correlated with outcome and data yielded. Results: Five of 14 patients (36%) suffered serious haemorrhage; four died (80%/28%). None of the nine patients without biopsy complications was in an acute sickling crisis at the time of biopsy. 4 of 5 patients with complications were. Four of these five patients 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%). Conclusion: Acute hepatic disease complicating sickle cell anaemia represents a newly identified contraindication to percutaneous liver biopsy.
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