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World J Gastroenterol. Nov 28, 2013; 19(44): 7825-7829
Published online Nov 28, 2013. doi: 10.3748/wjg.v19.i44.7825
Published online Nov 28, 2013. doi: 10.3748/wjg.v19.i44.7825
Is liver biopsy necessary in the management of alcoholic hepatitis?
Ashwin D Dhanda, Peter L Collins, C Anne McCune, Department of Liver Medicine, University Hospitals Bristol NHS Foundation Trust, Bristol BS2 8HW, United Kingdom
Ashwin D Dhanda, School of Clinical Sciences, University of Bristol, Bristol BS2 8HW, United Kingdom
Author contributions: Dhanda AD wrote the draft; Collins PL and McCune CA critically reviewed and revised the manuscript.
Correspondence to: C Anne McCune, FRCP, MD, Department of Liver Medicine, University Hospitals Bristol NHS Foundation Trust, Marlborough Street, Bristol BS2 8HW, United Kingdom. anne.mccune@uhbristol.nhs.uk
Telephone: +44-117-3422632 Fax: +44-117-3423353
Received: June 28, 2013
Revised: August 28, 2013
Accepted: September 15, 2013
Published online: November 28, 2013
Processing time: 165 Days and 21.2 Hours
Revised: August 28, 2013
Accepted: September 15, 2013
Published online: November 28, 2013
Processing time: 165 Days and 21.2 Hours
Core Tip
Core tip: Acute alcoholic hepatitis (AAH) is a clinical syndrome of jaundice and coagulopathy in a patient with a recent history of heavy alcohol consumption. Clinical diagnosis is challenging and transjugular liver biopsy remains the gold standard. Here we discuss the literature which demonstrates there is a lack of agreement between clinical and histological diagnosis. This, together with limited availability of transjugular liver biopsy makes it impossible to advocate universal biopsy in all suspected cases of AAH. We suggest further research is conducted to prospectively compare histological and clinical parameters and to develop a reliable and accurate non-invasive diagnostic tool.