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"Liver has normal size with coarse echo pattern" what does it indicate for?

Hi to All,

I am 39 Male .. here is my yesterday ultrasound and some blood test ..

ultrasound: " ... Liver has normal size with coarse echo pattern, no focal lesion and no dilated IHBR. Normal PV and CBD. Normal hepatic viens .... Conclusion: Chronic Parenchymatous liver disease for laboratory correlation"

several blood test showed:
ALT: 67.5
AST: 41.3
ALT and AST are higher than usual .. iam on entecavir .5mg since 1st of September 2012 .. before using entecavir .. ALT does not exceed 42 and ALT always lower than ALT ..

HDL 57.2
LDL 124.5
CHOL 192.4
ALP 64
CRP Negative
RBC 5.1
WBC 3.6
Platelet 158

I am HBeAg Negative .. PCR result does not show today .. it will show within 10 days .. i expect and hope it will be undetectable .. because i am naive patient .. started with baraclude .5mg ..
in last August .. Fibroscan gave 6.2 kpa .. before using enecavir ..
i use milk thistle, vit d3 5000 iu, curcum, omega 3 .. not everyday .. but almost everyday .. some of them ..

my questions are:
1. "Coarse echo Pattern" what does it mean for liver?

2. Is there any medicine or supplement can remove this coarse echo pattern?

3. why do ALT and AST increase? (i used antibiotic because of influenza for last three weeks)

4. what are PV and CBD?

5. Can Entecavir solve the coarse echo problem?

6. How can I increase WBC and Platelet?

May Allah cure all of us ..

Thank you ..
6 Responses
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Avatar universal
Liver shope and exhotrxture.no foacl sol seen.ihbr are not dilated

Hindy me
Helpful - 1
Avatar universal
if there is no hepatitis then what are reasons of spleen enlargement and Coarse echo Pattern" over the liver ..?
Helpful - 0
Hepatitis simple means liver inflammation. There are several virus that cause liver inflammation hepatitis A, Hepatitis B, Hepatitis C and so on. But those virus are not the only causes of liver inflammation (Hepatitis)

The most common causes are:

Chronic alcohol abuse
Chronic viral hepatitis (hepatitis B and C)
Fat accumulating in the liver (nonalcoholic fatty liver disease)
Other possible causes include:

Iron buildup in the body (hemochromatosis)
Cystic fibrosis
Copper accumulated in the liver (Wilson's disease)
Poorly formed bile ducts (biliary atresia)
Inherited disorders of sugar metabolism (galactosemia or glycogen storage disease)
Genetic digestive disorder (Alagille syndrome)
Liver disease caused by your body's immune system (autoimmune hepatitis)
Destruction of the bile ducts (primary biliary cirrhosis)
Hardening and scarring of the bile ducts (primary sclerosing cholangitis)
Infection, such as schistosomiasis or syphilis
Medications such as methotrexate
All those medical conditions can cause liver inflammation and damage and eventually to liver cirrhosis.

This is an old thread is from 2013

I suggest you start a new thread with your own question
There are many causes of splenomegaly, including but not limited to portal hypertension.
Avatar universal
Thank you Advocatez ..
Helpful - 0
Avatar universal
WBC:  When my husband was doing a very difficult treatment in 2010, his WBC dropped, and his hepatologist put him on Neupogen.  Neupogen (filgrastim) is a man-made form of a protein that stimulates the growth of white blood cells in your body.
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Avatar universal
I really thank you Mike ..
Your long answer is very appreciated ..
Helpful - 0
Avatar universal
I am not a doctor so please keep that in mind. I will try to provide what little information I know.

1. "Coarse echo Pattern" what does it mean for liver?

I believe this suggests liver fibrosis. With liver disease there is inflammation which in time can cause the liver tissue to become fibrotic (liver fibrosis) I believe that you have liver fibrosis and not cirrhosis because the report states that your liver is normal size.

2. Is there any medicine or supplement can remove this coarse echo

The echo pattern reflects the condition of your liver which is the result of your underlying disease - Hepatitis B. Treatment of the Hep B is the key and that's why you take entecavir. I am not familiar with the course of Hep B progression or the possible beneficial effects of treatment so I don't know whether you can expect an improvement in the condition of your liver (liver histology).

3. why do ALT and AST increase? (i used antibiotic because of influenza for last three weeks)

ALT specifically and to a lesser extent AST increase in response to liver cell death. As the cells die enzymes are released. In my opinion your ALT and AST are only mildly elevated and I would not be alarmed by your numbers.

4. what are PV and CBD?

PV is portal vein - the primary blood source to your liver. Blood from your gastrointestinal tract and spleen flows through your portal vein into your liver. Yours is normal.

CBD is common bile duct. Again, your is normal.

Common bile duct: The duct that carries bile from the gallbladder and liver into the duodenum (upper part of the small intestine). The common bile duct is formed by the junction of the cystic duct, from the gallbladder, and the common hepatic duct, from the liver.

See: http://www.medterms.com/script/main/art.asp?articlekey=2804

5. Can Entecavir solve the coarse echo problem?

I said about all I know about this issue above in question #2.

6. How can I increase WBC and Platelet?

There is a drug that can increase platelet count - eltrombopag. I don't know whether this drug in appropriate in a patient with Hep B. In my opinion your platelet count is within the normal range - yours would probably be characterized as low normal. I have only seen eltrombopag used in Hepatitis C patients who were treating their Hep C with drugs that destroy platelets and those patients had platelet counts 50,000 and less. Yours is 158,000 and on my lab sheet the low normal is 140,000.

WBC? I don't have any idea about increasing this marker.

Helpful - 0
Hepatic parenchymal coarsened echo pattern on ultrasound is nonspecific, possibly artifactual or pathologic (e.g., hepatocellular disease including but not limited to hepatitis). While this can eventually lead to fibrosis, it would be premature to jump to this condition based on this pattern only. Fibrosis can be evaluated with elastography (aka FibroScan which you listed above).

The liver receives a dual blood supply from the hepatic portal vein and hepatic arteries. The hepatic portal vein supplies 75% of the blood to the liver, while the hepatic arteries supply the remaining 25%.
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