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bilirubin question
is a high bilirubin always prevalent with cirrhosis of the liver?
in other words, is it possible to have cirrhosis and always had a low bilirubin?
just curious.
Thanks,
Bree
in other words, is it possible to have cirrhosis and always had a low bilirubin?
just curious.
Thanks,
Bree
Sorry. Wrong link. This is a overview of cirrhosis.
http://www.medicinenet.com/cirrhosis/article.htm
Hectorsf
http://www.medicinenet.com/cirrhosis/article.htm
Hectorsf
I agree with all the above comments.
Liver cirrhosis can manifest itself in various ways depending on the cause of the damage to the liver and in different individuals. There are multiple complications that are caused by cirrhosis but they appear at different times in individuals or perhaps not at all.
If cirrhosis is suspected a liver biopsy can be performed to confirm the existence of cirrhosis.
As Bill said there is a qualitative difference between compensated and decompensated cirrhosis. Once decompensated cirrhosis exists in time the liver will continue to fail over time and at some point a liver transplant will be needed for a patient to continue to live.
Some people with compensated cirrhosis will remain stable over a period of many years and may end up dying from another illness.
High bilirubin is a complication of decompensated cirrhrosis and is one of 3 blood tests used to assess how ill a patient is and when they will need a liver transplant to survive.
Once a patient becomes cirrhotic (compensated or decompensated) they are at risk for liver cancer. Which is another reason for patients to try to stop the source of damage to their liver if possible.
Diagnosis of Cirrhosis:
The doctor will ask about medical history, family history of liver disease, diet, alcohol consumption, medications, and risk factors for hepatitis B and C, such as intravenous drug use. During a physical examination, the doctor determines whether the liver feels harder or larger than normal, if the Spleen is enlarged, looks for skin changes such as bruising and jaundice, and looks for evidence of fluid swelling in the legs, ankles, feet or abdomen.
Blood tests may be ordered to look for evidence of liver inflammation, bilirubin retention, a buildup of toxins or abnormal results of other substances made by the liver. The liver may be viewed using techniques such as ultrasound, CT scan with contrast or MRI. Cirrhosis may be confirmed by a biopsy, in which a tiny sample of liver tissue is removed through a needle and then examined for scarring and damage to cells.
For more information about cirrhosis see the AASLD Practice Guidelines for Cirrhosis
http://www.aasld.org/practiceguidelines/Practice%20Guideline%20Archive/Management%20of%20Adult%20Patients%20with%20Ascites%20Due%20to%20Cirrhosis2004.pdf
Cheers.
hectorsf
Liver cirrhosis can manifest itself in various ways depending on the cause of the damage to the liver and in different individuals. There are multiple complications that are caused by cirrhosis but they appear at different times in individuals or perhaps not at all.
If cirrhosis is suspected a liver biopsy can be performed to confirm the existence of cirrhosis.
As Bill said there is a qualitative difference between compensated and decompensated cirrhosis. Once decompensated cirrhosis exists in time the liver will continue to fail over time and at some point a liver transplant will be needed for a patient to continue to live.
Some people with compensated cirrhosis will remain stable over a period of many years and may end up dying from another illness.
High bilirubin is a complication of decompensated cirrhrosis and is one of 3 blood tests used to assess how ill a patient is and when they will need a liver transplant to survive.
Once a patient becomes cirrhotic (compensated or decompensated) they are at risk for liver cancer. Which is another reason for patients to try to stop the source of damage to their liver if possible.
Diagnosis of Cirrhosis:
The doctor will ask about medical history, family history of liver disease, diet, alcohol consumption, medications, and risk factors for hepatitis B and C, such as intravenous drug use. During a physical examination, the doctor determines whether the liver feels harder or larger than normal, if the Spleen is enlarged, looks for skin changes such as bruising and jaundice, and looks for evidence of fluid swelling in the legs, ankles, feet or abdomen.
Blood tests may be ordered to look for evidence of liver inflammation, bilirubin retention, a buildup of toxins or abnormal results of other substances made by the liver. The liver may be viewed using techniques such as ultrasound, CT scan with contrast or MRI. Cirrhosis may be confirmed by a biopsy, in which a tiny sample of liver tissue is removed through a needle and then examined for scarring and damage to cells.
For more information about cirrhosis see the AASLD Practice Guidelines for Cirrhosis
http://www.aasld.org/practiceguidelines/Practice%20Guideline%20Archive/Management%20of%20Adult%20Patients%20with%20Ascites%20Due%20to%20Cirrhosis2004.pdf
Cheers.
hectorsf
The prothrombin time (PT) and its derived measures of prothrombin ratio (PR) and international normalized ratio (INR) are measures of the extrinsic pathway of coagulation. They are used to determine the clotting tendency of blood, in the measure of warfarin dosage, liver damage, and vitamin K status. PT measures factors I, II, V, VII, and X. It is used in conjunction with the activated partial thromboplastin time (aPTT) which measures the intrinsic pathway.
The reference range for prothrombin time is usually around 11–16 seconds; the normal range for the INR is 0.8–1.2. Clinicians desiring therapeutic anticoagulation may aim for a higher INR - in many cases 2.5 - using anticoagulants such as warfarin.[1]
The result (in seconds) for a prothrombin time performed on a normal individual will vary depending on what type of analytical system it is performed. This is due to the differences between different batches of manufacturer's tissue factor used in the reagent to perform the test. The INR was devised to standardize the results. Each manufacturer assigns an ISI value (International Sensitivity Index) for any tissue factor they manufacture. The ISI value indicates how a particular batch of tissue factor compares to an internationally standardized sample. The ISI is usually between 1.0 and 2.0. The INR is the ratio of a patient's prothrombin time to a normal (control) sample, raised to the power of the ISI value for the analytical system used.
See: http://en.wikipedia.org/wiki/Prothrombin_time
Clotting time (INR) is one factor that can be helpful in determining the condition of the liver. If it takes longer to clot than normal that could indicate a liver problem.
When you have a longer clotting time and an elevated bilirubin, decreased albumin, a low platelet count etc. it suggests that cirrhosis may be present.
Mike
The reference range for prothrombin time is usually around 11–16 seconds; the normal range for the INR is 0.8–1.2. Clinicians desiring therapeutic anticoagulation may aim for a higher INR - in many cases 2.5 - using anticoagulants such as warfarin.[1]
The result (in seconds) for a prothrombin time performed on a normal individual will vary depending on what type of analytical system it is performed. This is due to the differences between different batches of manufacturer's tissue factor used in the reagent to perform the test. The INR was devised to standardize the results. Each manufacturer assigns an ISI value (International Sensitivity Index) for any tissue factor they manufacture. The ISI value indicates how a particular batch of tissue factor compares to an internationally standardized sample. The ISI is usually between 1.0 and 2.0. The INR is the ratio of a patient's prothrombin time to a normal (control) sample, raised to the power of the ISI value for the analytical system used.
See: http://en.wikipedia.org/wiki/Prothrombin_time
Clotting time (INR) is one factor that can be helpful in determining the condition of the liver. If it takes longer to clot than normal that could indicate a liver problem.
When you have a longer clotting time and an elevated bilirubin, decreased albumin, a low platelet count etc. it suggests that cirrhosis may be present.
Mike
Thanks, never had heard of that.
so taking this INR test gives you PT and PTT results? is that all you would have to order from doctor is INR test? And this gives you additional information on the shape of your liver?
so taking this INR test gives you PT and PTT results? is that all you would have to order from doctor is INR test? And this gives you additional information on the shape of your liver?
No, although esophageal varices are a product of portal hypertension, not every cirrhotic patient will develop these; particularly in early stages. EGD looks for these varices, Bree.
http://en.wikipedia.org/wiki/Portal_hypertension
Cirrhosis can be diagnosed by liver biopsy, lab results including bilirubin, INR, albumin, platelets, by physical exam, or by combination of the above.
-Bill
http://en.wikipedia.org/wiki/Portal_hypertension
Cirrhosis can be diagnosed by liver biopsy, lab results including bilirubin, INR, albumin, platelets, by physical exam, or by combination of the above.
-Bill
I do, a neighbor down the street.
And does an EGD normally show cirrhosis, even early cirrhosis?
And does an EGD normally show cirrhosis, even early cirrhosis?
Bree, if the insult to the organ continues, then I think progression to decompenasation is likely.
With compensated disease, if the condition that precipitated the cirrhosis is removed, i.e. virus, alcohol, etc then the liver will usually heal; or at least it’s not likely to progress.
However, if the patient’s liver has decompensated, then they’ll eventually require transplant in the future, regardless of their viral status.
Of course, there are probably exceptions to the above; these are generalities. Do you know someone with cirrhosis you're concerned about?
--Bill
With compensated disease, if the condition that precipitated the cirrhosis is removed, i.e. virus, alcohol, etc then the liver will usually heal; or at least it’s not likely to progress.
However, if the patient’s liver has decompensated, then they’ll eventually require transplant in the future, regardless of their viral status.
Of course, there are probably exceptions to the above; these are generalities. Do you know someone with cirrhosis you're concerned about?
--Bill
Hi Bill, strange, I had posted this response I thought....
Anyway, does compensated always go into decompensated?
Anyway, does compensated always go into decompensated?
Many people are taken by surprise when they’re diagnosed with early cirrhosis; they haven’t a clue they have developed it.
On the other end of the spectrum ascites, encephalopathy, esophageal hemorrhaging might occur.
Cirrhosis suggests a significant change in hepatic architecture. With compensated cirrhosis, the liver continues with its functions; it synthesizes, metabolizes, filters etc. When the liver decompensates, these functions are radically altered or eliminated.
-Bill
On the other end of the spectrum ascites, encephalopathy, esophageal hemorrhaging might occur.
Cirrhosis suggests a significant change in hepatic architecture. With compensated cirrhosis, the liver continues with its functions; it synthesizes, metabolizes, filters etc. When the liver decompensates, these functions are radically altered or eliminated.
-Bill
what symptoms do people have when they have cirrhosis? and what is the short story difference between compensated and decompensated?
Cirrhosis can be present in the absence of high bilirubin. As tashka points out, bilirubin alone will not rule in or rule out cirrhosis. As example, my husband has had cirrhosis for at least four years, and his bilirubin has always been in normal range.
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