Impossible to interpret Fibrotest

[meeta4065]

hello every one , i receive my sister's fibrotest who is suffering of fulminante hepatitis , but suprisingly its  written at the bottom of the results that .Fibrotest score and actitest score uninterpretable .
Alat is1179 UI/ML , Billiribine total 320 umol/L Billirubine congigated 269 ,GGT 472 UI/ML ,Hepatoglobine 0.86 Apo-Lipoproteine A1 0.44 g/l , Alpha -2-Macroglobuline 1,30 g/l,  
My question is , its my first time hearing that , can this be cause of the elevation of this tests? or is fibrose score is higher than F4? pls help

[meeta4065]

how do we know that someone is undergoing a liver failure ? what are the lab tests that confirm that ? Biopsi , fibroscan , ecography..... thanks

[StephenCastlecrag]

As far as I know, Fibroscan and ultrasound imaging are not useful. Biopsy may be too risky. Doctors would have a better idea. It seems a good sign to me that they are not keeping her in hospital.

[meeta4065]

Good sign? can she get well without treatment ? can billirubine drops down alone? i head that high alat sometimes is a good signe , but i don't realy understand than . one doctor told me billirubine can not drop down alone but high alat may be a good signe for hbsag clearance . im lost , i understand nothing . High alat is a sign that the liver is getteing damage ,but how can the liver regenerate alone without treament . pls can you clearify me . thanks

[meeta4065]

i thought Jaundice (yellowing of eyes and skin) is already a sign of liver failure though there is absent of Ascites (fluid in the belly) True or false ?

[meeta4065]

please one symtomp i forgot , her eyes are very yellow

[StephenCastlecrag]

I am not a doctor. It is still my opinion that your sister should be in hospital because she is experiencing very severe symptoms. Not knowing her Hepatitis B history, she can be suffering from liver failure due to paracetamol overdose, acute on chronic liver failure, decompensation etc. Low serum HBsAg in the context of cirrhosis is nether here or there, I suppose.
All the best

[meeta4065]

ok thanks , yes she was in the hospitle but doctors are saying nothing good , they gave her some drugs, interferon tablets and other drugs , and ask her to go and wait 2 weeks before comming . A friend told me the treatment is not  enough. I took her to CHU to meet an hepatologist , but nothing strange .

[meeta4065]

StephenCastlecrag , please do you have an idea why her hbsag quantity very low ? 150 ui/ml mean while she has chronique hepatitis B

[StephenCastlecrag]

Low HbsAg is good generally, but the state of the liver is more important. I don't think she was given "interferon" tablets as interferon is usually given as an injection. Jaundice and itching are most likely due to high biirubin level. Anyway, she is in the care of doctors, hopefully it is not progressing to liver failure and she will recover.

[meeta4065]

she has not been sleeping for a week now , she has skin ichings. very tired ,Where do you classify her with this symptomps  '''high ALT flare or experiencing liver failure.''    

    Her fulminate hepatitis was caused by paracetamol because hepatitis D is negatif , B positif ,but im surprise that her aghbs quantity is very low 150ui/ml ,mean while Ac hbc igG is positif . How can you explain that ;
Thanks for first reply

[meeta4065]

asat is 624 ui/m
igE 691 UI:ML
alp 284 normal 3-61

[meeta4065]

GLU2 103 .UREL 32.47 .ALB2 4.70
CREJ2 1.0 CA2 9.38 . CHLORIDE 113
POTASIUM 4.7 SODIUM 150

[StephenCastlecrag]

I don't know much about Fibrotest/ActiTest because it is a proprietary test. But it is stated in a BioPredictive guide to its tests that "The Tests have to be deferred for: acute hemolysis, acute hepatitis, acute inflammation".
Since your sister's ALT is very high, Fibrotest/ActiTest cannot be used. Fulminate  Hepatitis is very serious and your sister should be in hospital - I hope she is just experiencing a high ALT flare and is not experiencing liver failure.