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Gastroenterology (Expert Forum)
Cirrhosis Caused By Haemochromatosis
Answered by
Kevin Pho, MD - Internal Medicine
KevinMD.com
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.
Cirrhosis Caused By Haemochromatosis
by almara, Oct 18, 2006 12:00AM
Three years ago I was diagnosed with haemochromatosis following some elevated liver function readings. A liver biopsy showed that the haemochromatosis had damaged the liver and caused cirrhosis. The biopsy read :-
“The liver architecture is disturbed with increased fibrous tissue and the appearances are those of an established micronodular cirrhosis. Large amounts of haemosiderin pigment are present within the hepatic parenchyma and iron containing pigment is also quite prominently displayed within the bile duct epithelium. All of the appearances are entirely typical of primary haemochromatosis.”
Since then phlebotomy has brought the ferritin level under control and for the last 18 months, liver function tests, taken at three month intervals, have returned to normal.
I have also had a total of four abdominal ultrasounds, the first three of which showed “mild hepatosplenomegaly with liver of slightly increased echogenicity but no focal lesions.” However, the latest ultrasound report reads:-
“There is no hepatosplenomegaly on this occasion. The liver parenchyma is slightly coarse in texture with increased reflectivity but no focal abnormality evident”.
I have three questions:-
(1) Looking at the range of cirrhosis of the liver, how serious is “micronodular cirrhosis”?
(2) Am I correct in assuming that the normal liver function tests, and the absence of hepatosplenomegaly, should both be viewed as positive signs?
(3) What does “the liver parenchyma is slightly coarse in texture with increased reflectivity” mean?
“The liver architecture is disturbed with increased fibrous tissue and the appearances are those of an established micronodular cirrhosis. Large amounts of haemosiderin pigment are present within the hepatic parenchyma and iron containing pigment is also quite prominently displayed within the bile duct epithelium. All of the appearances are entirely typical of primary haemochromatosis.”
Since then phlebotomy has brought the ferritin level under control and for the last 18 months, liver function tests, taken at three month intervals, have returned to normal.
I have also had a total of four abdominal ultrasounds, the first three of which showed “mild hepatosplenomegaly with liver of slightly increased echogenicity but no focal lesions.” However, the latest ultrasound report reads:-
“There is no hepatosplenomegaly on this occasion. The liver parenchyma is slightly coarse in texture with increased reflectivity but no focal abnormality evident”.
I have three questions:-
(1) Looking at the range of cirrhosis of the liver, how serious is “micronodular cirrhosis”?
(2) Am I correct in assuming that the normal liver function tests, and the absence of hepatosplenomegaly, should both be viewed as positive signs?
(3) What does “the liver parenchyma is slightly coarse in texture with increased reflectivity” mean?
Doctor's Answer
by Kevin Pho, MD, Oct 18, 2006 12:00AM
, Oct 18, 2006 12:00AM
To answer your questions:
1) There is no description of the severity of the cirrhosis. "Micronodular cirrhosis" can have varying degrees of severity.
2) Later-stage cirrhosis can present with normal LFTs as well as an abscence of hepatomegaly. I would not assume any prognostic information based on these findings.
3) This is a characteristic description of the liver. Increased reflectivity refers to an ultrasound finding. Some cysts, masses or scarring may affect or present with increased or decreased ultrasound reflectivity.
These questions can be discussed with your personal physician.
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.
Kevin, M.D.
kevinmd_
1) There is no description of the severity of the cirrhosis. "Micronodular cirrhosis" can have varying degrees of severity.
2) Later-stage cirrhosis can present with normal LFTs as well as an abscence of hepatomegaly. I would not assume any prognostic information based on these findings.
3) This is a characteristic description of the liver. Increased reflectivity refers to an ultrasound finding. Some cysts, masses or scarring may affect or present with increased or decreased ultrasound reflectivity.
These questions can be discussed with your personal physician.
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.
Kevin, M.D.
kevinmd_
