When to consider a Liver Biopsy
A liver biopsy is an invasive operation that is used to remove a sample of a liver tissue.
The most common reason for doing a liver biopsy is when the level of your liver enzyme, ALT, is at normal range, but on the other hand, a liver ultrasound scan suggests the existence of a non-alcoholic fatty liver.
This scenario isn’t very common, but it does happen to some people.
The fact that your ALT enzyme level is at normal range doesn’t mean you have nothing to worry about.
If you have any evidence, specifically a liver ultrasound, that suggests you have a fatty liver, there is a need for further diagnosis, and a liver biopsy is the only way to accurately see not only the amount of fat, but also if there is an inflammation, scar tissue, and necrosis (deal liver cells).
Again, despite having normal liver enzyme level, you need to proceed to a biopsy if there is no evidence of a fatty liver in an ultrasound scan.
In addition, patients with Insulin Resistance (a pre-diabetic state), or other problems related to Glucose Metabolism, are at higher risk for the development of an advanced liver disease.
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April 18th, 2009 at 7:23 PM
“Most liver experts would recommend trying to lower the ALT enzyme levels before performing a liver biopsy”
Would a biopsy be appropriate if:
-Patient has been diagnosed with Fatty Liver
-enzymes had spiked in the past but are now within normal range
-Has had growing consistent aching on right side at the bottom of the rib cage for several weeks (appendix issues have been ruled out)
April 19th, 2009 at 1:44 AM
Adam, its very conditional. In a case where a patient has been already diagnosed with fatty liver, and liver enzyme levels have been lowered, a liver biopsy isn’t recommended.
Is this particular case, a liver biopsy might be considered to rule out other conditions the patient has.
July 10th, 2010 at 7:39 PM
can someone help me with this. I have been having pain in my stomach and my liver test was 143/99. my doctor says that she does not what is casuing this, she thinks that it may be my liver and is requesting to take pictures of my liver, do ya think i have fatty liver. my father was a alcoholic. Thanks
November 17th, 2010 at 3:30 AM
Levie,
You should go through liver function blood test and abdominal ultrasound. Please consult with a doctor for further instructions.
- Mark
August 3rd, 2011 at 1:42 AM
My wife had very high levels of ALT in October last year (over 2500). By February of this year they had returned to normal levels. She had a liver ultrasound scan in November which did not show any abnormality. Following a routine blood test in June, her ALT level was again high at 1,500. What would cause this? Her consultant has recommended a liver biopsy.
August 7th, 2011 at 5:51 AM
I went for an ultra-sound and the doctors office called and said I had fatty liver. They set up a consult with the Gastro doctor in a few weeks. My alt was 198 and the alp was 66. I have hemochromotosis and have a ferritin level of 398. Do you think I will have to get a biopsy? All the other organs I said were fine. I am overweight, 39, and drink too much. Not every day but normally my fair share on Friday/Saturday. I have no pain or other symptoms associated with liver disease as I have researched. Thanks.
August 10th, 2011 at 2:04 AM
Hi Mike,
The uniqueness of fatty liver disease is that it doesn’t really have any “real life” symptoms. The fact you do not have any pain doesn’t mean you do not have the disease.
The blood test is only the first step for proper fatty liver diagnosis. A biopsy is needed only at certain cases, and in your case I would suggest taking an abdominal ultrasound scan.
The ultrasound scan should show up exactly what type of fatty liver you have (alcoholic or non-alcoholic). The fact that you are overweight and drink alcohol, could mean either way.
Best regards,
Dr. Mark Bar-Gomel
August 18th, 2011 at 10:07 AM
My ALT and AST levels have remanded consistent and with in range for the past several years ( except for last month they jumped to 82 on a scale of 30-65) however my platelet count has dropped over the past several years it is 156 on scale of 159 -386 and has been consist. One Gastroenterologist stated to me that the low platelet number points to cerrhosis while a 2nd Gastroenterologist didn’t even review my platelet number and until I brought it up felt I had no issues with my liver at all. What is you opinion regarding platelet count and cirrhosis?
August 29th, 2011 at 7:20 AM
Hi, I recently had some blood tests done and my doctor phoned saying my ggt was high, also esr. In march my ggt was 46 and June it was 70, a week later it was 72. My doctor sent me for an ultrasound scan, I’m waiting on the results but the doc doing the scan said my liver doesn’t look fatty or damaged. What does this mean? Will I need further testing if nothing shows up on my scan. I went to the doctors with many symptoms weight loss being 1. I was diagnosed with uterine fibroids and a polyp. Had polyp removed and awaiting op for removal of fibroids. I’m on decapeptyl injections, could that cause my ggt to rise?
Nic
September 8th, 2011 at 2:11 PM
I have been diagnosed with non alcholic fatty liver. They want to do a liver biopsy to see what stage it is in…does this make sense?
September 13th, 2011 at 9:24 AM
Hello Ileannj,
There are some cases what a liver biopsy is needed. I’m not familiar with your specific case, but a liver biopsy is typically needed when there are sign of fatty liver in ultrasound scan but the blood test results show normal enzyme levels.
Have they told you the reason behind the need for liver biopsy?
Regards,
Dr. Mark Bar-Gomel
October 27th, 2011 at 9:09 AM
Hello doctor
For some days i had slight pain on my right abdomen, today i went to the doctor, and done ultrasonography..
and the report is hepatomegaly… and written LIVER IS ENLARGED 145mm… I am only 24, female.. 5′ 3″‘…weight 80 kg
pls doctor tell me is something serious??
November 9th, 2011 at 7:23 AM
Hello Silvia,
Liver enlargement can be causes by many reasons. Have you done any liver functions blood test?
If so, please share the results?
Regards,
Dr. Mark Bar-Gomel
December 27th, 2011 at 9:30 PM
Hi I was diagnosed with fatty liver 3 years ago. Recently I had another ultrasound done and they found a lesion on the left lobe of my liver. I then had a CT scan done and the doctor told me that it only could confirm the lesion but he was unable to specify what type of lesion it was. My doctor suggested waiting 3 months and then having another CT scan done to see if the lesion grows in size. I am 30 yrs old and do not drink much, I have also completely changed my diet and am now working out every day. I am scared it could be cancer and do not know why he could not tell me what type of lesion it was. Should i consider a biopsy in the mean time? My AFP level of 1.7 and all other tests except for my enzyme levels were within normal ranges.
Thank you