Effectiveness of liver biopsy in diagnosing liver diseases using a five-point diagnostic scale among pediatric population.

Abstract

Objective: To determine the effectiveness of liver biopsy using a five-point scale for establishing the diagnosis of underlying liver diseases in children with unexplained derangement of liver function tests. Study Design: Cross-sectional study. Setting: Department of Pediatric Medicine, National Institute of Child Health Karachi, Pakistan. Period: 1^st February 2024 to 30^th July 2024. Methods: A total of 221 patients were enrolled setting the inclusion criteria as children of either gender of age up to 14 years with deranged liver function tests and unexplained diagnosis warranting liver biopsy, or those in whom ultrasound abdomen and CT scan findings indicated liver diseases requiring biopsy for diagnosis. A 5-point scale was used for confirming the diagnostic yield of the liver biopsy. Results: In a total of 221 children, 120 (54.3%) were male. The median age was 3.00 (1.30-6.00) years. The most common diagnosis at the time of admission were chronic liver disease, glycogen storage disease, and Neimann-Pick disease, 102 (46.2%), 53 (24.0%), and 21 (9.5%) patients, respectively. For CLD, the sensitivity and specificity were 55.4%, and 90.8%, respectively. Chronic liver disease with portal hypertension showed a sensitivity of 82.4% and specificity of 100%, while neonatal cholestasis exhibited 100% sensitivity and specificity. Glycogen storage disease also demonstrated high sensitivity and specificity at 94.3% and 98.2%, respectively. Conclusion: The five-point scale used in our study provides a comprehensive framework for interpreting biopsy results and guiding clinical management.