Quote:
Originally Posted by JHop11
It wouldn't make any difference in treatment/management to have a second Bx. Even if the biopsy showed improvement, and someone is still experiencing symptoms, they're treatment will stay the same. Biopsies are not always used to monitor clinical progression. sometimes they are simply used for diagnosis.
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I disagree and agree.
In many cases insurance requires certain treatments to be done first, before proceeding to a higher cost treatment. A follow up biopsy after 6 month course of immune suppression for autoimmune neuropathy, may confirm that fiber density has not improved and therefore allow patient to receive higher dollar treatments like IVIG.
It can also be used to continue IVIG treatments by showing improvement (whether or not the patient still has symptoms).
However, you are correct that biopsies are sometimes used simply for dx. Sometimes, this is enough to get approval for treatments like IVIG and insurance doesn't question it down the road for continued therapy.
Don't forget that some treatments carry high risk or possible reactions. For some patients that may have some decrease in symptoms (but still some problems) the f/u biopsy is very helpful to SEE exactly what is being accomplished and if just more time is needed or it's not worth proceeding.
It's a case by case decision as for whether the f/u biopsy is helpful or warranted.