Aa
confused
I'm not sure where to begin, but here goes. 5 years ago I had a back surgery that went wrong and was unable to walk, within 3 days I had bacterial meningitis which took 3 months in the hospital to fight, When I finally went home I had nerve damage from the waist down. However I can now walk and am semi normal. a year ago I had alot of bowel issues and pain in my left side so I was taken in for a CT Scan which during the process the drs found my liver to be extremely large. a few months later I began to get sick alot so my local dr ran blood tests. It came back that my AST was 375 and my ALT was 590. My local Dr said to just lose some weight and exercise. Well that did not sit well with me so I sought a second opinion at one of the largest hospitals in the country. they began alot of tests and then did a transjugular biopsy do to fluid. Yesterday I got the results of that biopsy. I have autoimmune hepititis, fatty liver disease and stage 4 cirrhosis. From what I understand the Autoimmune is going to make treatment very difficult as they will have to stop my immune system from attacking my liver first. I cannot be a candidate for a transplant until the autoimmune is under control as it will attack the good liver as well. I am very confused right now and haven't decided to I fight like heck or live while I can?
I just want to urge you to pay close attention to Hector's post above. He is absolutely correct about what you need to do, and I hope you do get to a liver transplant clinic ASAP. Even if you can't get one now, and even if you aren't sure if you would want one, these doctors are still by far the best to take care of someone in your condition. Just go and let them help you figure things out. Come back to this cirrhosis forum whenever you need support or help figuring out something they've said (some of these docs are slightly impaired in the use of layman's English). Best wishes!
COMMUNITY LEADER
You must see a hepatologist at a liver transplant center as soon as possible. They are the only doctors that can care for someone like yourself with AIH and other medical conditions.
You need to be assessed, monitored and reated now...
"Absolute Indications for Treatment
Three randomized, controlled trials have demonstrated that patients with serum AST levels of at least 10-fold the upper limit of the normal range (ULN) or more than five-fold ULN in conjunction with a serum c-globulin level more than two-fold ULN have a high mortality (60% at 6 month) if untreated. Furthermore, histological findings of bridging necrosis or multilobular necrosis at presentation progress to cirrhosis in 82% of untreated patients and are associated with a 5-year mortality of 45%.These laboratory and histological findings of disease severity at presentation are absolute indications for corticosteroid treatment
Incapacitating symptoms associated with hepatic inflammation, such as fatigue and arthralgia, are also absolute indications for treatment
regardless of other indices of disease severity."
Patients with AIH cirrhosis should undergo ultrasound at 6 months intervals to detect HCC as in other causes of liver cirrhosis.
AIH is the indication for liver transplantation (LT) in approximately 2%-3% of pediatric and 4%-6% of adult recipients in the United States and Europe.
LT is indicated for patients presenting with acute liver failure, and it is the treatment of choice for patients progressing to decompensated cirrhosis with a MELD score of 15 or those with hepatocellular carcinoma
meeting transplant criteria. Need for LT may result from a failure to diagnose and treat AIH as an etiology of cirrhosis, inadequate response or intolerance to immunosuppressive therapy or noncompliance with
treatment.
Recurrent AIH in transplant donor livers occurs in approximately 30% of adult and pediatric patients (range 12%-46%) with an average time to recurrence of 4.6 years."
Please get an appointment with a liver transplant soon. It will give you the best chance of having a good outcome.
Don't give up! You still have many options available and a long life ahead of you.
University of Virginia
Transplant Clinic
1300 Jefferson Park Avenue, 4th Floor
Charlottesville, VA 22903
800.543.8814
Hector
You need to be assessed, monitored and reated now...
"Absolute Indications for Treatment
Three randomized, controlled trials have demonstrated that patients with serum AST levels of at least 10-fold the upper limit of the normal range (ULN) or more than five-fold ULN in conjunction with a serum c-globulin level more than two-fold ULN have a high mortality (60% at 6 month) if untreated. Furthermore, histological findings of bridging necrosis or multilobular necrosis at presentation progress to cirrhosis in 82% of untreated patients and are associated with a 5-year mortality of 45%.These laboratory and histological findings of disease severity at presentation are absolute indications for corticosteroid treatment
Incapacitating symptoms associated with hepatic inflammation, such as fatigue and arthralgia, are also absolute indications for treatment
regardless of other indices of disease severity."
Patients with AIH cirrhosis should undergo ultrasound at 6 months intervals to detect HCC as in other causes of liver cirrhosis.
AIH is the indication for liver transplantation (LT) in approximately 2%-3% of pediatric and 4%-6% of adult recipients in the United States and Europe.
LT is indicated for patients presenting with acute liver failure, and it is the treatment of choice for patients progressing to decompensated cirrhosis with a MELD score of 15 or those with hepatocellular carcinoma
meeting transplant criteria. Need for LT may result from a failure to diagnose and treat AIH as an etiology of cirrhosis, inadequate response or intolerance to immunosuppressive therapy or noncompliance with
treatment.
Recurrent AIH in transplant donor livers occurs in approximately 30% of adult and pediatric patients (range 12%-46%) with an average time to recurrence of 4.6 years."
Please get an appointment with a liver transplant soon. It will give you the best chance of having a good outcome.
Don't give up! You still have many options available and a long life ahead of you.
University of Virginia
Transplant Clinic
1300 Jefferson Park Avenue, 4th Floor
Charlottesville, VA 22903
800.543.8814
Hector
http://www.medhelp.org/forums/Hepatitis-Autoimmune/show/224
http://www.medhelp.org/forums/Cirrhosis-of-the-Liver/show/1390
Hi,
I am very sorry for what you are experiencing.
As this is the Hepatitis C forum, I do not think you will get many replies as most of us are not familiar with hepatitis autoimmune. Try the links above and hopefully you will get some help.
I would also recommend that you get a referral to a Hepatologist as soon as possible.
All the best to you
http://www.medhelp.org/forums/Cirrhosis-of-the-Liver/show/1390
Hi,
I am very sorry for what you are experiencing.
As this is the Hepatitis C forum, I do not think you will get many replies as most of us are not familiar with hepatitis autoimmune. Try the links above and hopefully you will get some help.
I would also recommend that you get a referral to a Hepatologist as soon as possible.
All the best to you
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