Which fatty liver patients need liver biopsy?

1. Focal fatty liver or diffuse fatty liver with normal liver islands (refers to the residual normal liver in diffuse fatty liver), which is difficult to distinguish from malignant tumors;

2. Identify the etiology of some rare fatty liver diseases, such as cholesteryl ester storage disease, glycogen storage disease, lenticular degeneration (Wilson disease), autoimmune hepatitis, etc.;

3. Determine whether there is steatohepatitis in patients with non-alcoholic fatty liver disease complicated by diabetes and metabolic syndrome;

4. After alcohol withdrawal, alcoholic liver disease does not improve, patients with alcoholic liver disease have unexplained clinical or biochemical abnormalities, and patients with alcoholic hepatitis need to exclude active infection before considering corticosteroid therapy;

5. After the body weight of obese fatty liver patients has decreased to 7% to 10% of the original weight, the liver enzyme indexes are still abnormal;

6. It is suspected that severe hepatitis is caused by fatty liver, and it is necessary to make a clear diagnosis and understand the cause;

7. If fatty liver or liver function damage caused by various causes is suspected, the main cause should be identified by liver biopsy;

8. Assess the reliability of certain serological indicators or imaging methods in the diagnosis of steatohepatitis and liver fibrosis

sex, and conducting clinical trials of new drugs for nonalcoholic steatohepatitis.

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