DÄ internationalArchive4/2013Thrombocyte Aggregation Inhibitors Are Important

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Thrombocyte Aggregation Inhibitors Are Important

Dtsch Arztebl Int 2013; 110(4): 59. DOI: 10.3238/arztebl.2013.0059a

Schultze, G

LNSLNS

In the review article entitled “The indications for liver biopsy” (1), the recommendations for coagulation say: “For safety, the platelet count should be above 50/nL, and the Quick value over 50% (e4).” Unfortunately the authors do not make any mention of platelet aggregation inhibitors.

In context of an expert report, the case of a patient was worked up in which, after a biopsy of a hepatic nodule with continued intake of acetylsalicylic acid, a massive hemorrhage occurred at the puncture site. The insurers declared non-liability because no guidelines or binding regulations exist in this scenario. The German-language literature does, however, provide recommendations according to which platelet aggregation inhibitors should be stopped in good time before a liver biopsy is undertaken (2, 3).

It would therefore be of general interest to find out where the authors stand with regard to this question.

DOI: 10.3238/arztebl.2013.0059a

Prof. Dr. med. Georg Schultze

Villingen-Schwenningen

GSchultze.VS@t-online.de.

Conflict of interest statement

The author has received honoraria for consultancy services from the medical service of the health insurance companies in Germany (Medizinischer Dienst der Kran­ken­ver­siche­rung, MDK) Saarland.

1.
Tannapfel A, Dienes HP, Lohse AW: The indications for liver biopsy. Dtsch Arztebl Int 2012; 109(27–28): 477–83. VOLLTEXT
2.
Glaser J, Pausch J: Perkutane Leberbiopsie – Empfehlungen der Deutschen Gesellschaft für Verdauungs- und Stoffwechselkrankheiten (DGVS) für die Durchführung endoskopischer Untersuchungen. 3rd edition. Demeter-Verlag Stuttgart 2002; 296–9. www.dgvs.de/media/6.1.Leberbiopsie.pdf.
3.
Semmo N, et al.: Die perkutane Leberbiopsie. Dtsch Med Wochenschr 2007; 132: 2643–5. CrossRef MEDLINE
1.Tannapfel A, Dienes HP, Lohse AW: The indications for liver biopsy. Dtsch Arztebl Int 2012; 109(27–28): 477–83. VOLLTEXT
2.Glaser J, Pausch J: Perkutane Leberbiopsie – Empfehlungen der Deutschen Gesellschaft für Verdauungs- und Stoffwechselkrankheiten (DGVS) für die Durchführung endoskopischer Untersuchungen. 3rd edition. Demeter-Verlag Stuttgart 2002; 296–9. www.dgvs.de/media/6.1.Leberbiopsie.pdf.
3.Semmo N, et al.: Die perkutane Leberbiopsie. Dtsch Med Wochenschr 2007; 132: 2643–5. CrossRef MEDLINE

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