What are the indications for liver biopsy in the evaluation of hemochromatosis?

Updated: Apr 03, 2017
  • Author: Andrea Duchini, MD; Chief Editor: Praveen K Roy, MD, AGAF  more...
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The use of liver biopsy in hereditary hemochromatosis can be restricted to those patients with a high probability of severe fibrosis or cirrhosis.

The American Association for the Study of Liver Diseases (AASLD) guidelines include the following indications for liver biopsy [7] :

  • All homozygotes with clinical evidence of liver disease

  • All homozygotes with serum ferritin greater than 1,000 ng/ml

  • All homozygotes older than 40 years with other risk factors for liver disease

  • Compound or C282Y heterozygotes with elevated transferrin saturation, particularly those who have had abnormal liver enzyme levels or clinical evidence of liver disease

See Workup for more detail.

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