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Cirrhosis of the Liver Community
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Avatar universal

fibroscan in cirrhosis

Is fibroscan an accurate procedure in assessing or evaluating stages of fibrosis to cirrhosis?
14 Responses
446474 tn?1446351282
COMMUNITY LEADER
Yes, VCTE  has been endorsed by American Association for the Study of Liver Diseases (AASLD), the organization that sets the standards for the study, diagnosis and treatment of liver disease in the US.


AASLD Endorses Vibration Controlled Transient Elastography

" The American Association for the Study of Liver Diseases (AASLD) endorses assessment of transient hepatic elastography. Devices using vibration controlled transient elastography (VCTE) have recently been approved by the FDA to be used by clinicians providing care for patients with liver disease to evaluate liver fibrosis at the point of care.

Measurement of transient elastography in assessing severity of liver disease is very well supported by a robust literature, extending back for more than a decade now. It is very clear that the use of this technique is:
*  Technically easy to perform and reproducible in more than 95% of patients
*  Safe and relatively inexpensive (particularly when compared with liver biopsy)
*  Correlates very well with the degree of hepatic fibrosis
 * Has utility in patients with other hepatitis C and other liver diseases

In addition, high levels of liver stiffness assessed by VCTE devices correlate well with subsequent clinical complications and even the risk of developing HCC.

The use of such devices has the potential to improve care of patients with advanced liver disease by providing accurate and non-invasive assessment of liver fibrosis, which when present is associated with a poorer prognosis. The use of the test will save the patients from needing liver biopsies, which are expensive and can have morbidity and
mortality. Furthermore, sampling variability with biopsies impairs their accuracy, a problem not present with VCTE.

This new technique has the potential to revolutionize the care of patients with chronic liver disease by improving the accurate management of their disease and lowering the cost of their care. "

Hector
Avatar universal
sorry jump on this thread, but i have had one of these scans and others:

Fibroscan  4.2kpa  233CAP (slightly above the 220 threshold)
Ultrasound , All perfectly normal
3 sets of bloods months apart
ALT 23 then 20 finally 20
AST 20  only the last set had this
GGT 23 then 19 finally 16
ALP 47 then 55 finally 50
Bili 1.9 then 1.3 and finally 1.3
Albumin 50 then 49 and finally 48

I am aiming to get rid of the slight fat, exercise, no alcohol and no sugars of fats.

Do I have anything to worry about with the information?  My albumin seems to be dropping, is this just normal fluctuations ?  Im having some bowel issues too , although I had confirmed Gastritis and I think a case of Acute Pancreatitis .
683231 tn?1467326617
Hi Ralph

My labs appear to use a different scale of g/dL which give a scale of 3.5-5.5 g/dL I am guessing fo ryour lab norms would be 35 to 55 so 40 would be a perfect average result so your Albubin is actually headed in the right direction

Here is mine from 01/06/14 before I satrted treatment for hep c for a comparision plus I have cirrhosis

Component              Standard Range      Your Value
ALT (GPT)                       <33 U/L                78
AST(GOT)                      0 - 50 U/L               54
ALK PTASE                39 - 117 U/L             103
BILIRUBIN, TOTAL      0.1 - 1.2 mg/dL           0.8
ALBUMIN, S                  3.5 - 5.5 g/dL           4.7

It does appear your bilirubin could be a bit elevated here is some info from web MD

http://www.webmd.com/digestive-disorders/bilirubin-15434?page=4

High values
•High levels of bilirubin in the blood may be caused by:
•Some infections, such as an infected gallbladder, or cholecystitis.
•Some inherited diseases, such as Gilbert's syndrome, a condition that affects how the liver processes bilirubin. Although jaundice may occur in some people with Gilbert's syndrome, the condition is not harmful.
•Diseases that cause liver damage, such as hepatitis, cirrhosis, or mononucleosis.
•Diseases that cause blockage of the bile ducts, such as gallstones or cancer of the pancreas.
•Rapid destruction of red blood cells in the blood, such as from sickle cell disease or an allergic reaction to blood received during a transfusion (called a transfusion reaction).
•Medicines that may increase bilirubin levels. This includes many antibiotics, some types of birth control pills, diazepam (Valium), flurazepam, indomethacin (Indocin), and phenytoin (Dilantin).


As you said you have Pancreatitis that can cause elevations in bilirubin.
Are you seeing a doctor for this?

here is a link from web Md about Acute Pancreatitis:

http://www.webmd.com/digestive-disorders/digestive-diseases-pancreatitis

What Are the Symptoms of Pancreatitis?
Symptoms of acute pancreatitis:

•Upper abdominal pain that radiates into the back. It may be aggravated by eating, especially foods high in fat.
•Swollen and tender abdomen
•Nausea and vomiting
•Fever
•Increased heart rate

How Is Pancreatitis Diagnosed?
To diagnose acute pancreatitis, doctors measure levels in the blood of two digestive enzymes, amylase and lipase. High levels of these two enzymes strongly suggest acute pancreatitis.

Doctors may also use other tests, such as:

•Pancreatic function test to find out if the pancreas is making the right amounts of digestive enzymes
•Glucose tolerance test to measure damage to the cells in the pancreas that make insulin
•Ultrasound and CT scan, which make images of the pancreas so that problems may be seen
•ERCP to look at the pancreatic and bile ducts using X-rays
•Biopsy, in which a needle is inserted into the pancreas to remove a small tissue sample for study
In more advanced stages of the disease, doctors may use blood, urine, and stool tests to confirm the diagnosis.

How Is Pancreatitis Treated?
Treatment for acute pancreatitis

People with acute pancreatitis are treated with IV fluids and pain medications in the hospital. In up to 25% of patients, the pancreatitis can be severe and patients may need to be admitted to an intensive care unit (ICU). In the ICU, the patient is closely watched because pancreatitis can damage the heart, lungs, or kidneys. Some cases of severe pancreatitis can result in death of pancreatic tissue. In these cases, surgery may be necessary to remove the dead or damaged tissue if an infection develops.

An acute attack of pancreatitis usually lasts a few days. An acute attack of pancreatitis caused by gallstones may require removal of the gallbladder or surgery of the bile duct. After the gallstones are removed and the inflammation goes away, the pancreas usually returns to normal.

Best of luck to you
Lynn
Avatar universal
the pancreatis described here is "severe acute"  you can have mild, moderate  acute pancreatitis.There was slight pain radiating to my back and my stools were yellow and greasy for a while.

Me and the Hep doc were just making a guess at what made me ill (no ct or amalaise test at the time), your thoughts on my labs appear to be incorrect, my bili was 1.9 and the range on that test was 1-1.9. In other words the Hep doc said that bili can be affected by an angry Pancreas. When I felt better my bili went down to 13 the range that time was 1-21  

Im not sure if your trying to scare me? MY VALUES ARE ALL HIGH?  At no time have my labs been elevated.

see again,more detail:

05/08/2014
ALT 23 IUL (0-41)
GGT 23 IUL (11-55)
ALP 47 UL (30-130)
BILI 19 UMOL
ALBUMIN 50 G/L

25/09/2014
ALT 20 IUL (0-41)
GGT 19 IUL (11-55)
ALP 55 UL (30-130)
BILI 13 UMOL
ALBUMIN 49 G/L

26/01/2015,DIFFERENT LAB
ALT  20 UIL (0-55)
AST 20 IUL (5-45)
GGT 16 IUL (12-64)
ALP 50 UL (30-150)
BILI 13.4 (1-21)
ALBUMIN 48GL (35-50)

Does this give a better picture?

683231 tn?1467326617
I was just using the red ranges on my labs I did not intent to concern you different labs do use different scales sorry if I concerned you needlessly as your lab uses a different scale.

I referenced acute pancreatitis as that was what you said you may have in your previous comment. The web md article did go on to discuss chronic as well as the various causes of pancreatitis.

I was only saying your bili looked high if it was on the same scale as mine all your other labs look great I wish mine looked so good I only thought the bili might be a little high but because your lab reports the results differently than mine that was my confusion.

Your Albumin is normal as well and by decreasing is becoming more towards average values so that is also fantastic.

I did not say all your labs were high just was confused about your bili which was the only result I expressed concern over. I posted my results for you to compare against if you were interested. The majority of the info was copied from the links. So maybe you read something from the quoted material that you thought was me speaking to your results. I apologize for any confusion I may have caused.

But yeah all your labs look great excellent even now that I know the scale your lab uses for the bilirubin. Always best to go with your doctors recommendations.

Wishing you good health
Lynn
Avatar universal
The bili is the only one different for some reason.  Most other values were in IU/L  which is the same as U/L?

I would still like to see my bili a little lower though. I think I had a moderate case of Pancreatitis.  So I will go to the doctors to get some tests aimed more at that, my blood sugers seem ok so far.  The Hep doc said all my Liver tests were pretty much text values, under healthy liver.  So it may appear all my liver paranoia was some what misplaced?
683231 tn?1467326617
Never hurts to be careful and you best resource for your health questi
683231 tn?1467326617
Questions is always your doctor. Me I work I  a machine shop at night and read a lot because I have hep c and cirrhosis

Glad it your doctor says you are fine
Avatar universal
out of interest what conversions were you using?
683231 tn?1467326617
I was looking at what units and ref ranges are in my results from Jan 2014:

Component              Standard Range      Your Value
ALT (GPT)                        <33 U/L                78
AST(GOT)                      0 - 50 U/L               54
ALK PTASE                39 - 117 U/L             103
BILIRUBIN, TOTAL      0.1 - 1.2 mg/dL        0.8
ALBUMIN, S                  3.5 - 5.5 g/dL          4.7

You can see lab corp here in WA state anyway for bilirubin uses mg/dL ( milligrams per deciliter ref range 0.1 - 1.2,  while you lab it seems uses UMOL with a scale of 1-21 so different scales entirely.

You will also note both my ALT and AST are above normal range due to the hep c virus attacking my liver.
Avatar universal
i see are those values under "your value" were actually what yours were?

My labs came back as stated in IU/L and ranges to right.My doc liked the low GGT and said ALT is very very good at 20
683231 tn?1467326617
Yes those are my labs from January 2014 before I treated for hep c from March to June. I relapsed in September and started treatment again with a different med in November. Will be done with meds in May.

My current labs look normal only one I have that is not normal is platelets. Normal is above 150 mine is 90.

This is my most recent Liver test results from January 13, 2015 much better due to my treatment

My results

Component Results   Value Std Range

ALBUMIN, S             4.5        3.5-5.5
BILIRUBIN, TOTAL      0.6        0.1-1.2
BILIRUBIN, DIRECT    0.2        0-0.4
ALT (GPT)              26         <33
AST(GOT)              23         0-50
ALK PTASE              82         39-117

Avatar universal
I pray you can be cured. I fully understand why you with much more serious issues get a little peeved with the anxious ones such as myself, when looking at my blood tests and scans I shouldnt be worrying so much. I do have anxiety issues and it runs in the family, not much I can do about it :(
My platelets dropped from 267k to 258k, im told this isnt a problem?

If your labs stay like that will your liver heal?
683231 tn?1467326617
No worries Ralph your questions are intelligent and well thought out.

Minimum normal for platelet count by the way my lab tests figures them, which your labs may be different, are 150 - 379 x10E3/uL so if you lab uses the same scale that looks excellent! Those numbers are just a statistical variation could have taken an aspirin and produced that change.

My platelet count is 90. At 30 the doctors consider doing blood transfusion but that is only a temporary fix as they will fall again due to my enlarged spleen which is enlarged because of my cirrhosis and portal hypertension.

I also have enlarged blood vessels in my throat called esophageal varicies that are also caused by portal hypertension. I had them eridicated by multiple banding sessions to prevent the possibility of a massive life threatening bleeding episode. I have to have an upper endoscopy every to make sure they have not come back.

If my liver heals my labs may return to more normal levels but as I have had liver cirrhosis for 7 years that may take a long time if ever to regain some function.

Actually on treatment my liver function tests are normal currently but my platelets continue to be very low.

If I beat the hep c virus at least the on going liver damage will stop and my liver will  have a chance to try to heal.

Good luck to you
Lynn
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