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Liver problems
Dear Doctor,
I have a past 3 year history of drinking alcohol, one bottle of wine a night. It was a hard time in my life. In 2007 I became pregnant and of course stopped drinking completely. I did not experience any serious withdrawal symptoms other then anxiety and nervousness. I delivered a healthy child at full term. During pregnancy I noticed getting these red dots (1-2mm) on my body and after consulting a dermatologist he mentioned that they usually appear in pregnancy or in patients with liver disease. Since the birth I had a cat scan, ultrasound, 4 liver function tests, 4 CBC's which all came back normal. The doctor even ran a full hep panel to ease my mind since I also was experiencing pain in my ruq area. I am still not convinced that my liver is healthy and want to have a biopsy done but my doctor doesn't want to do this. He wants to do an EGD to rule out any internal bleeding but doesn't think a biopsy is necessary. Here are my questions.
Is it possible that I have alcoholic liver disease?
Can someone with alcoholic liver disease become pregnant and deliver a healthy child?
Could a ct scan or ultrasound miss liver disease?
Can lft's or platelets fluctuate?
Here are my recent lab results.
Total Bilirubin 0.5 range (0.2-1.5)
Protein total 7.0 range (6.5-8.1)
Albumin 3.8 range (3.5-4.8)
AST 19 range (15-41)
ALT 12 low range (14-54)
ALK Phos 42 range (32-91)
Dbilirubin 0.1 range (.1-.5)
Platelets 243 range (150-400)
PT 9.9 range (8.9-11.4)
INR0.9
APTT 27 range (24-35)
I haven't had any alcohol for two years (since 2007) and don't have any desire to drink. It was just a bad and difficult time of my life. I know biopsy is the only way to tell if there is any liver disease present. What are your thoughts? Thank you very much.
I have a past 3 year history of drinking alcohol, one bottle of wine a night. It was a hard time in my life. In 2007 I became pregnant and of course stopped drinking completely. I did not experience any serious withdrawal symptoms other then anxiety and nervousness. I delivered a healthy child at full term. During pregnancy I noticed getting these red dots (1-2mm) on my body and after consulting a dermatologist he mentioned that they usually appear in pregnancy or in patients with liver disease. Since the birth I had a cat scan, ultrasound, 4 liver function tests, 4 CBC's which all came back normal. The doctor even ran a full hep panel to ease my mind since I also was experiencing pain in my ruq area. I am still not convinced that my liver is healthy and want to have a biopsy done but my doctor doesn't want to do this. He wants to do an EGD to rule out any internal bleeding but doesn't think a biopsy is necessary. Here are my questions.
Is it possible that I have alcoholic liver disease?
Can someone with alcoholic liver disease become pregnant and deliver a healthy child?
Could a ct scan or ultrasound miss liver disease?
Can lft's or platelets fluctuate?
Here are my recent lab results.
Total Bilirubin 0.5 range (0.2-1.5)
Protein total 7.0 range (6.5-8.1)
Albumin 3.8 range (3.5-4.8)
AST 19 range (15-41)
ALT 12 low range (14-54)
ALK Phos 42 range (32-91)
Dbilirubin 0.1 range (.1-.5)
Platelets 243 range (150-400)
PT 9.9 range (8.9-11.4)
INR0.9
APTT 27 range (24-35)
I haven't had any alcohol for two years (since 2007) and don't have any desire to drink. It was just a bad and difficult time of my life. I know biopsy is the only way to tell if there is any liver disease present. What are your thoughts? Thank you very much.
Dr. Schiano,
Thank you so much for your respond. I always read that the only way to diagnose liver disease related to alcohol was a biopsy since blood tests could be normal and related symptoms could appear after months or even years. My gastroenterologist said the images would have picked up something. I am just very worried and am planning to have another child with my husband but don't know if it is safe for the baby and me.
Thanks again.
Thank you so much for your respond. I always read that the only way to diagnose liver disease related to alcohol was a biopsy since blood tests could be normal and related symptoms could appear after months or even years. My gastroenterologist said the images would have picked up something. I am just very worried and am planning to have another child with my husband but don't know if it is safe for the baby and me.
Thanks again.
MEDICAL PROFESSIONAL
the red spots can normally during preganancy appear, whether one has liver disease or not. i see absolutely no reason to have a liver biopsy as long as you remain abstinent. definitely people with liver conditions can deliver a health baby; you do not have a liver condition. do not worry, do not drink. your blood tests are totally normal.
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