Cryptogenic liver

[lisa812]

I was recently diagnosed with cryptogenic liver disease. My biopsy came back stage 3, bridging fibrosis, moderately active chronic hepatitis. My GI started me on prednisone, 40mg times 2 weeks, then tapering to 30mg, and finally 20mg. First cmp after the 40mg came back with normal ast and alt levels, they had been elevated to 300+ and 500+. I spoke to a surgeon I know recently, and he said I am facing transplant one day, that the prednisone is buying me time. Just wondering if, in your experience, does this type of liver dysfunction always result in a liver transplant? And if so, could you possibly estimate on how much time I may have prior to the transplant? Thanks.

Lisa

[Thomas D Schiano, MD]

if the liver tests responded to steroids then you may have autoimmune hepatitis.  as long as patients are treated appropirtaely medically they will have a normal life expectancy and the need for transplant will be obviated.  you might want to get your liver biopsy interpretted by an experienced liver pathologist to confirm the diagnosis as you do not want to be taking steroids longer than you really have to.

i hope this is helpful.

[cat33]

I was also diagnosed with cryptogenic liver disease Stage 4, bridging fibrosis, mild active chronic hepatitis. The one thing I don't understand is why I was not placed on any type of medications. Other than lactulose for encephalopath. I have a meld score of 9 but was recently told by an anesthisiologyst that this is the most aggressive forms of liver disease, which progresses so quickly that people often don't have a chance to get a liver transplant. Is this True. No one has told me how bad off I really am . Other than saying I am at ESLD. I feel reletively normal other than tired.
Any response would be greatly appreciated

[Thomas D Schiano, MD]

if one has autoimmune hepatitis the disease can stabilized with medical therapy and delay or obviate the need for a liver transplant.  Chronic active hepatitis could also be from HCV or another cause though.

[cat33]

I was negative for A, B, and C hepatitis. I did have A as a Child and a severe infection of the gallbladder about 20yrs ago. which did do some damage. Was tested for Autoimmune because my sister has Lupus , was told I did not have that although after recently looking over my old lab results one of the says Positive ANA2. That is confusing to me. I also tested positive several times for MONO and EBV no one ever mentioned any thing about that either.

[Thomas D Schiano, MD]

mono and EBV are essentially the same thing.  ANA at high titer could be seen in lupus or autoimmune hepatitis.