Comment explorer une hépatopathie chronique d'origine indéterminée ?

Most patients with chronic liver disease have alterations in liver laboratory tests. This situation is common and could affect up to 8% of patients in primary care. These abnormalities are associated with long-term excess mortality, both general and related to liver complications. In the majority of cases, these causes are easily identified through questioning, clinical examination, and blood-biological tests. Patients without identified cause require additional work-up looking for rare liver diseases. However, the cause of liver disease remains undetermined in nearly 10% of cases. In absence of validated diagnostic -algorithm the management of patients is highly heterogeneous especially for the indication of liver biopsy. These liver abnormalities remain unexplained at the end of these explorations. A rationale and hierarchized approach combining precise analysis of medical history, utilisation of laboratory tests using reference technics, magnetic resonance imaging, liver biopsy and new generation sequencing are able to provide an etiologic diagnosis in the majority of patients. [ABSTRACT FROM AUTHOR]