Liver Biopsy

Liver biopsies are no longer required to make a definitive diagnosis of HH and are much less commonly performed in suspected HH. However, a liver biopsy can be helpful in several different ways, including the following: (1) it gives the clinician an assessment of the amount of iron and its cellular and lobular distribution, (2) it provides an important assessment of hepatic fibrosis, and (3) it allows for the investigation of other concomitant liver diseases that may not be readily detectable using noninvasive analysis.

The hepatic iron concentration (HIC) can be measured in fresh or paraffin-embedded biopsy material, and the normal level is less than 1,500 ^g/g dry weight. Evidence suggests that most patients with HFE-associated HH do not develop hepatic fibrosis until the HIC exceeds 14,000 ^g/g dry weight; concomitant ethanol consumption is a potentiating factor in the development of cirrhosis in patients with iron overload (Fletcher et al, 2002).

Although liver biopsy can provide useful information, it remains an invasive test with well-documented risks. Consequently, recent studies have evaluated several clinical and biochemical factors in an attempt to predict the absence of cirrhosis in patients with HFE-associated HH

to obviate the need for liver biopsy. It has been reported that C282Y homozygotes with serum ferritin levels

< 1000 ng/mL, with normal liver enzymes, and who are

< 40 years of age are unlikely to have cirrhosis, so that liver biopsy may be unnecessary in such patients (Bacon et al, 1999).

Constipation Prescription

Constipation Prescription

Did you ever think feeling angry and irritable could be a symptom of constipation? A horrible fullness and pressing sharp pains against the bladders can’t help but affect your mood. Sometimes you just want everyone to leave you alone and sleep to escape the pain. It is virtually impossible to be constipated and keep a sunny disposition. Follow the steps in this guide to alleviate constipation and lead a happier healthy life.

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