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"Liver has normal size with coarse echo pattern" what does it indicate for?
Hi to All,

I am 39 Male .. here is my yesterday ultrasound and some blood test ..

ultrasound: " ... Liver has normal size with coarse echo pattern, no focal lesion and no dilated IHBR. Normal PV and CBD. Normal hepatic viens .... Conclusion: Chronic Parenchymatous liver disease for laboratory correlation"

several blood test showed:
ALT: 67.5
AST: 41.3
ALT and AST are higher than usual .. iam on entecavir .5mg since 1st of September 2012 .. before using entecavir .. ALT does not exceed 42 and ALT always lower than ALT ..

HDL 57.2
LDL 124.5
CHOL 192.4
ALP 64
CRP Negative
RBC 5.1
WBC 3.6
Platelet 158

I am HBeAg Negative .. PCR result does not show today .. it will show within 10 days .. i expect and hope it will be undetectable .. because i am naive patient .. started with baraclude .5mg ..
in last August .. Fibroscan gave 6.2 kpa .. before using enecavir ..
i use milk thistle, vit d3 5000 iu, curcum, omega 3 .. not everyday .. but almost everyday .. some of them ..

my questions are:
1. "Coarse echo Pattern" what does it mean for liver?

2. Is there any medicine or supplement can remove this coarse echo pattern?

3. why do ALT and AST increase? (i used antibiotic because of influenza for last three weeks)

4. what are PV and CBD?

5. Can Entecavir solve the coarse echo problem?

6. How can I increase WBC and Platelet?

May Allah cure all of us ..

Thank you ..
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4 Answers
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Avatar universal
I am not a doctor so please keep that in mind. I will try to provide what little information I know.


1. "Coarse echo Pattern" what does it mean for liver?

I believe this suggests liver fibrosis. With liver disease there is inflammation which in time can cause the liver tissue to become fibrotic (liver fibrosis) I believe that you have liver fibrosis and not cirrhosis because the report states that your liver is normal size.

2. Is there any medicine or supplement can remove this coarse echo
pattern?

The echo pattern reflects the condition of your liver which is the result of your underlying disease - Hepatitis B. Treatment of the Hep B is the key and that's why you take entecavir. I am not familiar with the course of Hep B progression or the possible beneficial effects of treatment so I don't know whether you can expect an improvement in the condition of your liver (liver histology).

3. why do ALT and AST increase? (i used antibiotic because of influenza for last three weeks)

ALT specifically and to a lesser extent AST increase in response to liver cell death. As the cells die enzymes are released. In my opinion your ALT and AST are only mildly elevated and I would not be alarmed by your numbers.

4. what are PV and CBD?

PV is portal vein - the primary blood source to your liver. Blood from your gastrointestinal tract and spleen flows through your portal vein into your liver. Yours is normal.

CBD is common bile duct. Again, your is normal.

Common bile duct: The duct that carries bile from the gallbladder and liver into the duodenum (upper part of the small intestine). The common bile duct is formed by the junction of the cystic duct, from the gallbladder, and the common hepatic duct, from the liver.

See: http://www.medterms.com/script/main/art.asp?articlekey=2804

5. Can Entecavir solve the coarse echo problem?

I said about all I know about this issue above in question #2.

6. How can I increase WBC and Platelet?

There is a drug that can increase platelet count - eltrombopag. I don't know whether this drug in appropriate in a patient with Hep B. In my opinion your platelet count is within the normal range - yours would probably be characterized as low normal. I have only seen eltrombopag used in Hepatitis C patients who were treating their Hep C with drugs that destroy platelets and those patients had platelet counts 50,000 and less. Yours is 158,000 and on my lab sheet the low normal is 140,000.

WBC? I don't have any idea about increasing this marker.

Mike
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I really thank you Mike ..
Your long answer is very appreciated ..
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WBC:  When my husband was doing a very difficult treatment in 2010, his WBC dropped, and his hepatologist put him on Neupogen.  Neupogen (filgrastim) is a man-made form of a protein that stimulates the growth of white blood cells in your body.
Advocate1955
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Thank you Advocatez ..
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