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August 1977

Fever of Unknown OriginAssessment of the Value of Percutaneous Liver Biopsy

Arch Intern Med. 1977;137(8):1001-1004. doi:10.1001/archinte.1977.03630200011007

This study was done to assess the value of percutaneous liver biopsy in the diagnosis of fever of unknown origin (FUO). We performed a retrospective analysis of all cases (43) seen at Vanderbilt University Hospital in the last 12 years in which a percutaneous liver biopsy was performed in the course of the evaluation or presence of FUO. The 43 patients who underwent biopsy were assigned to three arbitrary groups: group 1, liver biopsy abnormal and helpful in diagnosis and often in therapy; group 2, liver biopsy abnormal but of no definite diagnostic and therapeutic value; group 3, liver biopsy normal or essentially normal. Distribution of the 43 patients in these categories was as follows: group 1, six individuals (13.9%); group 2,11 patients (25.6%), and group 3, 26 patients (60.5%). Group 1 patients had hepatomegaly three times as often (P <.05) and abnormal liver function tests 25% more commonly (P >.05) than the other two combined groups, but the overlap was substantial in both parameters. We conclude that percutaneous liver biopsy may be helpful in a positive manner in the diagnosis of FUO but only in a very small number of cases; that a surprisingly large number of patients with FUO are undiagnosed, but the overall prognosis is relatively good; and that in view of newly available diagnostic techniques and the small fraction of all cases of FUO that undergo biopsy, a prospective evaluation of the role of percutaneous liver biopsy in the diagnosis of FUO using a larger number of cases is warranted.

(Arch Intern Med 137:1001-1004, 1977)