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Hep B and Liver Cirrhosis
Hello there
I have a question regarding my mom who has Hep B for the last few years. She did ultrasound 5 months ago after blood test shows some change comparing to the past and I recieved the call from Health Professional from the Hospital telling me first that her Liver is okay but later that she has a lot of scars on her liver and that the doctor wants to do biopsy in order to determine the condition of my mom's liver. We didn't go back but we actually turned to a healthy food and mom started taking one therapy with natural teas which we bought back home from one doc of natural medicine who is very well known in Balkan area for curing liver diseases.
My mom did blood test about 10 days ago and it came back as very normal and with very good results. Her family doctor said the results are very good and so far the best. However, I took my mom to the same Hospital where she did liver ultrasound and we talked with this lady, NP, who told us that we need another ultrasound in a month ( bc of health insurance covering every 6 mo ) and to see what's going on. But, she shocked me when she said my mom's liver has cirrhossis according to the last ultrasound test that she did 5 months ago. I asked for the copy of ultrasound and I showed it to two doctors who said they can NOT see any signs of scars tissue or cirrhossis whatsoever. Mom is feeling great, normal and all good although she had some kind of depression and stress a few months ago when she was about to do ultrasound test but for the past few months, without stress or anything she has no major or even minor problem with health. Now, my question is: How can they say a lot of scars on her liver and this NP even said cirrhossis when on the copy of ultrasound said this:
"Liver: The Liver is normal in size and echogenicity. The echotexture is smooth. No focal intraphetic mass is identified. There is no intraphetic biliary ductal dilatation. There is hepatopetal flow in the main portal vein. The surface of the liver is smooth. ARFI measurements were acquired: 1. 21, 2.17, 2.25, 2.8, 2.95, 3.42, 3.7, 4.17. Resultant ARFI median is 2.9 m/s."
I am afraid that they actually think there is cirrhossis or scars tissue according to this ARFI measuremtns as her median is 2.9 m/s. Can someone explain to me, please ?
"ABDOMINAL AORTA AND IVC: The visalized portions in the upper abdomen are unremarkable."
PANCREAS: The visualized portions of the pancreas are unremarkable.
SPLEEN: The spleen is normal in size.
KIDNEY: Survey sagittal images of both kidneys show no hydronephrosis. There is a smple cortical cyst measuring 0.9 x 0.9 x 0.9 cm in the posterior cortex of the right kidney."
OTHER: There is no fluid in the uppear abdomen.
IMPRESSION: Unremarkable ultrsound of the liver. ARFI measuremtns as above. " - That's it about ultrasound.
This ultrasound was performed in June this year/last summer. Now I am posting blood test that she did 10 days ago:
BLOOD SUGAR 89 / range: 65-110 mg/dl
UREA NITROGEN BLOOD ( BUN ) 17 / range 6-24
CREATININE, BLOOD 0.73 / range 06-1.4
BUN/CREAT 23.3 / range 5-26,
SODIUM 140 / range 135-148,
POTASSIUM 4.4 / rangr 3.5-5.5,
CHLORIDER 105 / range 98-108,
ALK PHOSPHATASE 44 range 35-115,
CARBON DIOXIDE 28.6 / Range 21-31
CALCIUM 9.5 / range 8.3 - 11.0,
SGOT/AST 19 / range 7-48,
TOTAL PROTEIN 7.1 / range 6.0-8.5,
ALBUMIN 4.5 / range 3.3-5.2,
TOTAL BILIRUBIN 0.65 / range 0.2 - 1.2
CBC WITH DIFF
WBC 5.8 / range 4.0 - 10. 0,
RBC 4.43 / range 4.1 - 5.4,
HEMOGLOBIN 14.5 / range 12.1 - 15.4,
HEMATOCRIT 43.5 / range 37.0 - 47.0,
MCV 98.1 range 82.0-99.0,
MCH 32.7 range 27.0-33,
MCHC 33.3 range 32.0-36.0,
RDW 12.3 range 11.5-14.5,
MPV 10.6 range 7.4 - 10.4,
PLATELET COUNT 161 range 130 - 400,
POLYS 41.8 range 40 - 75,
EOSINOPHIL 1.3 range 0.0 - 6.0,
BASOPHIL 0.2 range 0.0 - 5.0,
LYMPHOCYTE 51.1 range 18.0 - 47.0,
MONOCYTE 5.6 range 0.0 - 12.0,
ABSOLUTE NEUTROPHIL COUNT 2.4 range 1.8 - 7.7
Hepatitis B DNA IU/ML 912
HEPATITIS B DNA COPIES/ML 5308
Comment: Reference range: Target Not Detected or <20 IU/ml ( Dynamic range: 20 - 170.000.000 IU/ML ) ( 116 - 989. 400.000 copies/ML )
This assay was performed using Rosche Taqman Polymerase Chain Reaction ( PCR ) Assay.
HEPATITIS B DNA LOG IU/ML 3.0
HEPATITIS B DNA LOG COPIES/ML 3.7
That would be all I have for right now.
Can anyone help me on this, please ?
Thank you
Al
I have a question regarding my mom who has Hep B for the last few years. She did ultrasound 5 months ago after blood test shows some change comparing to the past and I recieved the call from Health Professional from the Hospital telling me first that her Liver is okay but later that she has a lot of scars on her liver and that the doctor wants to do biopsy in order to determine the condition of my mom's liver. We didn't go back but we actually turned to a healthy food and mom started taking one therapy with natural teas which we bought back home from one doc of natural medicine who is very well known in Balkan area for curing liver diseases.
My mom did blood test about 10 days ago and it came back as very normal and with very good results. Her family doctor said the results are very good and so far the best. However, I took my mom to the same Hospital where she did liver ultrasound and we talked with this lady, NP, who told us that we need another ultrasound in a month ( bc of health insurance covering every 6 mo ) and to see what's going on. But, she shocked me when she said my mom's liver has cirrhossis according to the last ultrasound test that she did 5 months ago. I asked for the copy of ultrasound and I showed it to two doctors who said they can NOT see any signs of scars tissue or cirrhossis whatsoever. Mom is feeling great, normal and all good although she had some kind of depression and stress a few months ago when she was about to do ultrasound test but for the past few months, without stress or anything she has no major or even minor problem with health. Now, my question is: How can they say a lot of scars on her liver and this NP even said cirrhossis when on the copy of ultrasound said this:
"Liver: The Liver is normal in size and echogenicity. The echotexture is smooth. No focal intraphetic mass is identified. There is no intraphetic biliary ductal dilatation. There is hepatopetal flow in the main portal vein. The surface of the liver is smooth. ARFI measurements were acquired: 1. 21, 2.17, 2.25, 2.8, 2.95, 3.42, 3.7, 4.17. Resultant ARFI median is 2.9 m/s."
I am afraid that they actually think there is cirrhossis or scars tissue according to this ARFI measuremtns as her median is 2.9 m/s. Can someone explain to me, please ?
"ABDOMINAL AORTA AND IVC: The visalized portions in the upper abdomen are unremarkable."
PANCREAS: The visualized portions of the pancreas are unremarkable.
SPLEEN: The spleen is normal in size.
KIDNEY: Survey sagittal images of both kidneys show no hydronephrosis. There is a smple cortical cyst measuring 0.9 x 0.9 x 0.9 cm in the posterior cortex of the right kidney."
OTHER: There is no fluid in the uppear abdomen.
IMPRESSION: Unremarkable ultrsound of the liver. ARFI measuremtns as above. " - That's it about ultrasound.
This ultrasound was performed in June this year/last summer. Now I am posting blood test that she did 10 days ago:
BLOOD SUGAR 89 / range: 65-110 mg/dl
UREA NITROGEN BLOOD ( BUN ) 17 / range 6-24
CREATININE, BLOOD 0.73 / range 06-1.4
BUN/CREAT 23.3 / range 5-26,
SODIUM 140 / range 135-148,
POTASSIUM 4.4 / rangr 3.5-5.5,
CHLORIDER 105 / range 98-108,
ALK PHOSPHATASE 44 range 35-115,
CARBON DIOXIDE 28.6 / Range 21-31
CALCIUM 9.5 / range 8.3 - 11.0,
SGOT/AST 19 / range 7-48,
TOTAL PROTEIN 7.1 / range 6.0-8.5,
ALBUMIN 4.5 / range 3.3-5.2,
TOTAL BILIRUBIN 0.65 / range 0.2 - 1.2
CBC WITH DIFF
WBC 5.8 / range 4.0 - 10. 0,
RBC 4.43 / range 4.1 - 5.4,
HEMOGLOBIN 14.5 / range 12.1 - 15.4,
HEMATOCRIT 43.5 / range 37.0 - 47.0,
MCV 98.1 range 82.0-99.0,
MCH 32.7 range 27.0-33,
MCHC 33.3 range 32.0-36.0,
RDW 12.3 range 11.5-14.5,
MPV 10.6 range 7.4 - 10.4,
PLATELET COUNT 161 range 130 - 400,
POLYS 41.8 range 40 - 75,
EOSINOPHIL 1.3 range 0.0 - 6.0,
BASOPHIL 0.2 range 0.0 - 5.0,
LYMPHOCYTE 51.1 range 18.0 - 47.0,
MONOCYTE 5.6 range 0.0 - 12.0,
ABSOLUTE NEUTROPHIL COUNT 2.4 range 1.8 - 7.7
Hepatitis B DNA IU/ML 912
HEPATITIS B DNA COPIES/ML 5308
Comment: Reference range: Target Not Detected or <20 IU/ml ( Dynamic range: 20 - 170.000.000 IU/ML ) ( 116 - 989. 400.000 copies/ML )
This assay was performed using Rosche Taqman Polymerase Chain Reaction ( PCR ) Assay.
HEPATITIS B DNA LOG IU/ML 3.0
HEPATITIS B DNA LOG COPIES/ML 3.7
That would be all I have for right now.
Can anyone help me on this, please ?
Thank you
Al
Best Answer
While this is the Hep C forum. I totally agree with your doctor and not the NP. Thers is nothing in her Ultrasound that suggests cirrhosis and her blood test looks great. Happy Thanksgiving.
2.6? This sound as more than a perfect liver but members can correct me if im wrong
Just some update.
I took my mom for fibroscan test today as recomended by some of you here.
Here is her results:
"The patient's score is 2.6, F0-F1 no or mild fibrosis."
So, for interpetation of this result see below:
F0 - F1 = 2.5 - 7.4 no or mild fibrosis
F2 = 7.5 - 9.4 moderate fibrosis
F3 = 9.5 - 12.4 severe fibrosis
F4 = 12.5 + cirrhosis
__________
So, mom's number is at 2.6 of F0 or 1.
I took my mom for fibroscan test today as recomended by some of you here.
Here is her results:
"The patient's score is 2.6, F0-F1 no or mild fibrosis."
So, for interpetation of this result see below:
F0 - F1 = 2.5 - 7.4 no or mild fibrosis
F2 = 7.5 - 9.4 moderate fibrosis
F3 = 9.5 - 12.4 severe fibrosis
F4 = 12.5 + cirrhosis
__________
So, mom's number is at 2.6 of F0 or 1.
The diagnosis of cirrhosis in your mom was apparently arrived at as a result of acoustic radiation force elastography, a new method to determine liver stiffness in several spots. It is a similar principle than the one in the Fibroscan test, but it uses acoustic frequencies instead of very low frequency shear wave propagation analysis. While there is less clinical experience and research available with this nrw technique compared to Fibroscan, a direct comparison has shown a good correlation of results between these two techniques.
The noninvasive determination of liver stiffness is obviously of extreme importance in practical hepatology and also represents a huge market for machine producing companies. A third method using shear wave propagation measurements is based on magnetic resonance imaging.
Spleen size, albumin and platelet values do not point to anything like advanced cirrhosis in your mom, but are not incompatible with mild cirrhosis. The morphological findings on the US also do not rule out that diagnosis.
Finding a place that performs Fibroscan is indeed your best choice to further clarify this issue.
The noninvasive determination of liver stiffness is obviously of extreme importance in practical hepatology and also represents a huge market for machine producing companies. A third method using shear wave propagation measurements is based on magnetic resonance imaging.
Spleen size, albumin and platelet values do not point to anything like advanced cirrhosis in your mom, but are not incompatible with mild cirrhosis. The morphological findings on the US also do not rule out that diagnosis.
Finding a place that performs Fibroscan is indeed your best choice to further clarify this issue.
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