Consequences of cryoglobulinemia?

Posted by Kendall on May 25, 1999 at 21:59:19
First thankyou for taking the time to read this. Here is my biopsy results from two years ago. I will let you read that because that is what my questions are going to be based on.
Surgical Pathology Tucson Medical Center
Clinical information received Specimen
Hepatitis C Liver biopsy
Gross:
The specimen consists of four fragments of tan-brown cylindrical tissue measuring 8mm in length. Tp/kg
MICRO:
Step sections of the liver biopsy demonstrate distortion of the normal hepatic architecture. There is a marked portal chronic inflammatory cell infiltrate and fibrosis with mild piecemeal necrosis. The hepatocytes demonstrate diffuse mild fatty metamorphosis and focal collections of lymphocytes within the lobules. A trichrome stain demonstrates focal bridging fibrosis/cirrhosis.

Diagnosis: Liver core biopsies: Chronic hepatitis with mild activity and cirrhosis.
My doctor told me that this was considered early cirrhosis. Then he checked my ammonia levels and they are high. He then said I have hepatic encephalopathy.  I also have tested postive for cryoglobulinemia. I have 3% cryo reading in my blood. I have vasculitis in my lower legs and suffer from very poor circulation. I am also just in the last couple of months starting to experience numbness in my arms and legs and feet. With all of this said...
1. Is the fact that I have hepatic encephalopathy put me in the end stage liver failure category?
2. Is it recommended that I go for treatment? It's my understanding that having the ammonia levels contraindicates treatment.
3. What are the disease consequenses of cryoglobulinemia. What is the treatment for this?
4. I have spider viens all over my chest and my back. What is the signifance of these?
5. Should I be scoped for varices at this time? Or should I wait until I have a bleed?
I will be going to the doctor in June and pursueing what my options are and getting a prescription for Lactulose. I appreciate any information you can share with me about all of this and sorry it is so long.
Thanks once again for your time.
Kendall

    
Posted by HFHSM.D.-D.M. on May 28, 1999 at 13:19:39

Dear Kendall:
I really appreciate your letter as well as how difficult your situation must be.  I