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Gastroenterology (Expert Forum)
ELISA-HCV ve; tot. bilirubin-2.5 mg/dL; direct bil-0.3; albumin-3.2 gm/dL
Answered by
Kevin Pho, MD - Internal Medicine
Kevin Pho, MD
Boston - MA
This forum is for questions regarding Gastroenterology issues such as Acid Reflux (GERD), Barretts Esophagus, Colitis, Colon/Bowel Disorders, Crohn's Disease, Diverticulitis/ Diverticulosis, Digestive Disorders, IBS, Stomach Pain.
ELISA-HCV ve; tot. bilirubin-2.5 mg/dL; direct bil-0.3; albumin-3.2 gm/dL
by Sunag, May 03, 2004 12:00AM
Dr. Kevin:
Mom is 58 years old vegetarian, never used alcohol or drugs.She has edema of her legs for the past 3 years- is on diuretics. 2 months ago was diagnosed with Jaundice and last week was tested for HCV and it was reactove. RIBA and RT PCR not done yet. Ultrasound of abdomen - liver is smaller in size and is nodular in contour, parenchymal echotexture-coarse. No IHBD, CBD is normal. Portal vein-10 mm and max vel. of blood flow is 16.9 cm/sec. No evidence of ascites, no lymphadenopathy, no effusion, no spenome- galy. Endoscopy of upper GI - oesophagus has bluish discoloration at lower end. Impression: Oesophageal varices Grade I. T.protein 6.6 gm/dL; ALP 317 U/L; SGPT 137 U/L; SGOT 256U/L. WBC 4.000Cumm, RBC 3.4 mill/Cumm. Haem 11.5 gm/dL. No acidity, stool normal color, sleep habits normal. Gastroenterologist prescribed Nexpro, liq. Duphalac, Aldactone, salt restricted diet and suggested Interferon/ribavarin therapy . Please evaluate and give your opinion. How serious is her condition? We are worried about the side effects of Interferon/Rib therapy.
Mom is 58 years old vegetarian, never used alcohol or drugs.She has edema of her legs for the past 3 years- is on diuretics. 2 months ago was diagnosed with Jaundice and last week was tested for HCV and it was reactove. RIBA and RT PCR not done yet. Ultrasound of abdomen - liver is smaller in size and is nodular in contour, parenchymal echotexture-coarse. No IHBD, CBD is normal. Portal vein-10 mm and max vel. of blood flow is 16.9 cm/sec. No evidence of ascites, no lymphadenopathy, no effusion, no spenome- galy. Endoscopy of upper GI - oesophagus has bluish discoloration at lower end. Impression: Oesophageal varices Grade I. T.protein 6.6 gm/dL; ALP 317 U/L; SGPT 137 U/L; SGOT 256U/L. WBC 4.000Cumm, RBC 3.4 mill/Cumm. Haem 11.5 gm/dL. No acidity, stool normal color, sleep habits normal. Gastroenterologist prescribed Nexpro, liq. Duphalac, Aldactone, salt restricted diet and suggested Interferon/ribavarin therapy . Please evaluate and give your opinion. How serious is her condition? We are worried about the side effects of Interferon/Rib therapy.
Doctor's Answer
by Kevin Pho, MD, May 04, 2004 12:00AM
, May 04, 2004 12:00AM
Next step would be waiting for confirmation of the hepatitis C - which is currently pending. Assuming it is positive, a liver biopsy should be obtained. This is useful in predicting the stage and prognosis of the disease.
As a general rule, patients who are considered for treatment should have histologic and virologic evidence of chronic infection (ie, HCV RNA detectable in serum) and an elevated serum ALT.
The ALT is clearly elevated in this case. Dependent on the biopsy as well as the serum results, then treatment for hepatitis C should certainly be considered.
Followup with your personal physician is essential.
This answer is not intended as and does not substitute for medical advice - the information presented is for patient education only. Please see your personal physician for further evaluation of your individual case.
Thanks,
Kevin, M.D.
As a general rule, patients who are considered for treatment should have histologic and virologic evidence of chronic infection (ie, HCV RNA detectable in serum) and an elevated serum ALT.
The ALT is clearly elevated in this case. Dependent on the biopsy as well as the serum results, then treatment for hepatitis C should certainly be considered.
Followup with your personal physician is essential.
This answer is not intended as and does not substitute for medical advice - the information presented is for patient education only. Please see your personal physician for further evaluation of your individual case.
Thanks,
Kevin, M.D.
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She was also diagnosed with "Cirrhosis of liver"-well compensated.
But does not have ascites, portal hypertension, varcieal bleed or encaphalopathy. What stage of Cirrhosis does she have?
She is warned that there is a possibility of the above conditions.
Is her condition a cofirmed case of Cirrhosis, based on the blood work , endoscopy & LFT results?
I would very much appreciate your response to this.
-Sunag