Susie,
This is so frustrating for us. I feel like if we only knew the cause we could fight back. My dad's bleeding has been getting worse by the week.l
I'm sorry to hear about your dad. Is it possible that because of the obesity he has something called NASH (non-alcoholic steatohepatitis?). That can cause fibrosis/cirrhosis and all the problems that go with it. They should have seen it on the biopsy I would think.
The portal hypertension is what is causing the spleen to enlarge and sequester (trap) his platelets. I hope the doctors can get to the bottom of the cause for his liver problems.
Anyway to increase ones platelets? My dad is really starting to have a lot of nose bleeds. :(
Here is an update and I am afraid it is not very good. My dad had another liver biopsy done last week and it appears that in two years it has progressed to Stage 4 liver disease. Though the portal inflammation is less and the report says that the fibrosis is similar to the report two years ago but there is now bridging and mention of "suggestive of cirrhosis".
His doctor has started the process to get him on a transplant list.
Once again, all tests for autoimmune, HEP virus, metals etc. have come back negative.
FLGuy,
Looks like you were right, my dads abdomen is enlarging because of fluid. The poor man has been dealing with this for years and we never knew.
He was put on another beta blocker to reduce portal hypertension.
His blood work (besides the platelets and RBC) are not all the bad, the billirubin is up slightly, the AST is at 60, the ALT is at 35.
Does ANYONE have any other ideas as to where we can look in the disease process to try to deal with what is causing this to occur that maybe someone is missing?
Thank you
I have some more information about my father.
RBC 3.8 4.20 to 5.80
WBC 3.9 3.8 to 10.8
PLT 59
MCV 102 80 to 100
MCH 36.2 27 to 33
BIL 2.0 .2 to 1.2
AST 60 10 to 35
ALT 35 9 to 60
Alkaline phosphatase 164 40 to 115
significant platelet clumping was observed upon microscopic review of a smear
From his Liver Biopsy of two years ago:
chronic portal inflammation and vague possible lymphoid aggregates. There was increased portal fibrosis with incomplete bridging resulting in piecemeal necrosis.
From what I am reading it sounds like my father was exposed to HEP. Is it possible to be exposed and not test postive?
Any additional info from anyone?
Again, not an expert. But, sometimes weight gain in people who have liver problems is retention of fluids in a condition call ascites. You might google it for more information.
Thank you,
I forgot to mention that my dad several years ago lost all of his hair on his legs too. Onyl from his hips down. He is a very hairy person including his legs, at least he used to be on his legs.
He saw a hepatologist two years ago who suggested the liver biopsy back then. But the only thing he suggested to my father at the time was to get gastric bypass to lose the weight. My father has never over eaten or eat bad foods but he just kept gaining more and more weight. I think this might somehow be related to the rest of this mess.
Does anyone have any other suggests or comments with regards to this issue?
Thanks again.
I'm sure not qualified to take a guess, but a couple of observations. Clearly the best way to assess what's happening with the liver is a bopbsy, so make sure the hepatologist gets a copy of the prior report. He may even request the slides. The hepatologist is a very good next step. The AST/ALT, AST is probably a ltitle high for range and ALT is with normal range. Platelets are low and when I had (still do) have low plates the term used was 'they were sequestered' in the spleen and I don't know exactly know what that means. Bring recent reports (labs) with you in some rational order it will help the doc divine a trend and a history. Good luck. Oh yeah, be ready to quantify and describe those otc and prescribed pain meds. A lot of them are tough on the liver.