provided that all the criteria for diagnosis has been fulfilled and alternative diagnosis are also ruled out. The patient has coagulopathy and transjugular biopsy wont be possible due to resource limitation and the on-going pandemic.
Fibrosing cholestatic hepatitis (FCH) is rapidly progressing. You can diagnose FCH by fibroscan, MRI, CT, and ultrasound which may also be done. Biopsy. A tissue sample (biopsy) is not necessarily needed for diagnosis and to determine the degree of fibrosis and to confirm the diagnosis
I think that is need to confirm diagnosis, histopathologically.
Often findings are: Microscopically lobules were markedly disarrayed, showing ballooning degeneration of hepatocytes, prominent pericellular fibrosis, and marked canalicular or intracytoplasmic cholestasis. Portal inflammation was mild, but interphase activity was definite and cholangiolar proliferation was prominent.
FCH is a term to define an unusual clinical and histopathological presentation of hepatitis B or C in severe immunosupressed patients with liver, kidney or bone marrow transplantation or chemotherapy with ominous prognosis.
It is difficult to ruled out other diferencial diagnosis with out liver biopsy. Histopatholigical findings is essencial for diagnosis : marked hepatocellular swelling, lobular disarray and cholestasis without portal or lobular inflammation; fibrosis surrounding the cholangioles.
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