Risks of Needle Biopsy of the Liver

Abstract

_~~~~~~~~~~~MIA JORA will therefore end in complete refractoriness, at which stage only free folic acid will produce haematological benefit. Without doubt, however, other unknown factors are in- volved, for folic acid is not always completely successful in curing the anaemia. Whatever the explanation, the beneficial clinical, nutri- tional, and haematological effect of folic acid in idiopathic steatorrhoea accompanied by megaloblastic anaemia makes accurate diagnosis a matter of great importance. It is all too easy, if anaemia is macrocytic and megaloblastic and associated with a histamine-fast achlorhydria, to diagnose Addisonian pernicious anaemia. In all such cases a careful assessment of the initial effect of parenteral liver extract or vitamin Bi is necessary, and, if not classical, a fat-balance test should be the next investigation irrespective of the gross appearance of the stools or a history of intestinal dysfunc- tion. A positive result from this somewhat laborious pro- cedure is an indication for vitamin B12 or liver to give place to folic acid.