A Study of Clinicopathological Association in Chronic Liver Disease - A Cross Sectional Study from a Tertiary Referral Hospital of South India

Abstract

BACKGROUND Chronic liver disease is a liver disorder of varying causes and severity with variable clinical, biochemical and histological findings with severity lasting for 6 months or more. The spectrum of chronic inflammatory diseases of the liver extends from acute hepatitis to chronic hepatitis and finally to cirrhosis. Whatever the aetiology, the same basic underlying histological changes may be seen in the liver. The objective of the study was to see the association of clinical diagnosis with the histopathological diagnosis among chronic liver disease patients. METHODS It is a cross-sectional study that included analysis of clinicopathological data of 40 patients with clinically suspected chronic liver disease who were admitted to the medical wards of government general hospital, Kakinada between March 2003 and May 2005. RESULTS Total number of patients (N = 40) of suspected chronic liver disease were included in the study in which 25 were males (62.5 %) and 15 were females (37.5 %). Most of the cases (36) were found in the age group of 30 - 69 years, a majority of 12 was in the age group of 50 - 59 years. The most common symptoms in this study were abdominal distension and loss of appetite in 28 (70 %) patients, followed by pain in abdomen 22 (55 %), jaundice 17 (42.5 %), loss of weight 16 (40 %), pedal oedema 11 (27.5 %). A total of 7 cases (41.7 %) of cirrhosis were seen in the age group of 40 - 49 years, 5 cases (45.45 %) with chronic hepatitis were in the age group of 50 - 59 years, 5 (45.45 %) hepatocellular carcinoma cases were in the age group of 60 - 69 years, hepatoblastoma was seen in a 60-year-old female. Clinical diagnosis was strongly associated with histopathology (Pearson chi-square value = 19.583, P = 0.021) and also showed fair agreement between clinical diagnosis and histopathology (P = 0.002). CONCLUSIONS Chronic liver disease is more in males, most commonly seen in the age group of 30 - 69 years and the majority of them are in the age group of 50 - 59 years. Cirrhosis is the most common chronic liver disease seen in North and Coastal Andhra, part of South India, followed by chronic hepatitis, hepatocellular carcinoma. The most common etiological factor is alcoholic abuse (35 %) followed by HBsAg positivity (15 %), native medicine in 5 % and unknown in 45 %. Clinical diagnosis of chronic liver disease should be confirmed with histopathological examination. In appropriate clinical settings, the clinical diagnosis of chronic liver disease made by experts is fairly associated with histopathological diagnosis. KEY WORDS Chronic Liver Disease, Clinical Diagnosis of Liver Disease, Histopathological Association