MRCP2-1900

MRCP2-1900

A 45-year-old woman with a history of hypothyroidism and Sjogren’s Syndrome presents to the emergency department with worsening jaundice and pruritus. She reports that these symptoms have been increasing over the past few months and she has been struggling to manage oral fluids for the past three days. She also reports having soft, pale stools.

Upon examination, the patient is markedly jaundiced and has a mildly distended abdomen. However, there are no masses or bleeding present and she is haemodynamically stable.

The following lab results were obtained: Bilirubin 89 µmol/l, ALT 150 u/l, ALP 450 u/l, gamma#GT 270 u/l, Albumin 27 g/l, and Platelets 300 *10^9/l. The PT is 17.7s and the APTT is 39.9s.

Tests for Hepatitis A IgM/IgG, HBsAg, and Hepatitis C DNA PCR all came back negative. A liver ultrasound showed dilated biliary ducts, no focal lesion, normal echogenicity, and small volume ascites around the liver.

What is the contraindication to biopsy in this case?