live cirrhosis question

[emilp59]

Hello,

I have been suffering from cirrhosis for quite some time now but nobody has been able to tell me the cause.
My latest fibromax results showed an increase in the fibrotest and steatotest. My previous fibrotest was : 0.83 now it's 0.88 and my steatotest was 0.43 and now it's 0.64. All this happened in 1 year in which I have gained about 7 kgs.
I would like to know when should I consider a liver transplant and what is causing the fibrossis to increase? The doctors I have asked in my country didn't provide a valid answer to this question. I can provide the tests via email or upload them somehow if they're needed.
Thank you.

[Thomas D Schiano, MD]

the function of the liver which is measured by lab tests appears normal so i am hopeful that transplant will not be ncessary for some time.  remember however there is a small, finite risk for the development of HCC, which could change things.

[emilp59]

Based on the state of degree can an appreciation be made to how many months or years until a transplant is needed?
Thank you.

[Thomas D Schiano, MD]

it could very well be fatty liver

[emilp59]

I have taken tests for viral hepatitis and partially for the auto-immune hepatitis. The analysis were:



Anti-HBs - 6.7 NEGATIVE mUI/ml

Total anti-HBc - 11.55 POSITIVE S/CO

HBeAg - 0.352 NEGATIVE

Anti-HBe - 0.08 POSITIVE

Viral Load VHB - Undetectable

Viral Load VHC - Undetectable

Delta-Ag - Negative

HBs-Ag - 0.27 NEGATIVE



Serum Iron - 175.00

Antinuclear Antibodies (ANA) - 0.2 NEGATIVE

Anti-LKM-1 Antibody < 3 NEGATIVE AU/ml

Mitochondrial Antibodies (AMA) < 3 NEGATIVE AU/ml

ASMA - 1/80 POZITIVE

Ac anti SLA - 8.86 NEGATIVE U/ml

Ferritin - 129.26 ng/ml

AFP - 2.79 ng/ml



LIVER



- left lobe AP=83mm : - central lobe TR= 36mm : -right lobe PR=13,2 cm

- borselated surface with multiple nodular areas(10-11mm). dysmorphic liver,  Mixed micro-and macronodular ecostructure, in some places macronodules with a diameter of 8 mm.

- no PLIH, repermeabilization schetch of U.O

- vascular design depleted decalibrated with echogenic perivascular cuffs, dysmorphic rigid character.



PORTAL VEIN:



- Right ramification trenchant, perivascular sleeve

- 12 mm diameter at the hilum
- Vm = 12.2 cm (I understand that is the appreciation rate, that if it was less than 8 cm at risk of thrombosis)



I tried to keep the translation as accurate as possible, because the original language is not english.

[Thomas D Schiano, MD]

do they believe that you have fatty liver?  The liver enzyme profile is unrevealing.  has testing for viral hepatitis and autoimmune hepatitis also been performed?

[emilp59]

no, a biopsy has never been taken.
thank you for the reply, I will post them here, both 2012 and 2013:

2012
fibrotest : 0.83
actitest: 0.32
steatotest: 0.43
ashtest: 0.01
nashtest: 0.25
alfa2-macroglobulin: 2.35
haptoglobin: 0.44
apolipoprotein A1: 1.38
total bilirubin: 36.00
ggt: 120
alt: 34
ast: 26
glicemia: 4.5
cholesterol: 3.96
triglicerides: 1.39

in 2013:

fibrotest : 0.88
actitest: 0.33
steatotest: 0.64
ashtest: 0.02
nashtest: 0.25
alfa2-macroglobulin: 2.02
haptoglobin: 0.311
apolipoprotein A1: 1.21
total bilirubin: 45.144
ggt: 165
alt: 33
ast: 28
glicemia: 6.051
cholesterol: 4.241
triglicerides: 2.021

If any other analysis are needed please let me know. Thank you for your time.

[Thomas D Schiano, MD]

please send me the other data--cases of true cryptogenic cirrhosis are infrequent.  have you ever had a liver biopsy?