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stages of ciarrhosis
I am going to have a fibroscan in a couple of weeks and i am expecting to have advanced liver fibrosis and ciarrhosis
(not sure if thats spelt right)! I have heard of ciarrhosis measured in terms of 'stages', can anyone give me any infomation on what the stages mean so that i can be a little prepared for my appointment?
Thanks so much
Lynne
(not sure if thats spelt right)! I have heard of ciarrhosis measured in terms of 'stages', can anyone give me any infomation on what the stages mean so that i can be a little prepared for my appointment?
Thanks so much
Lynne
I cant quite remember something i need to find out, but i seem to think i was on a very low dose.
Lynne
Lynne
Hi Lynne,
I had multiple spider nevi on face, shoulders and chest; but my biopsy indicated stage 3-4 damage. I think there are other conditions outside of cirrhosis that can cause spider nevi too; they’re not exclusive to liver disease. When they appear with other signs such as stiff liver margins and known HCV they might be more suggestive of cirrhosis, though.
Regarding the question you asked Deb about the ‘ordinary scan’. An ultrasound scan is an excellent diagnostic tool for determining many things; it can locate masses, tumors, size organs and veins; things like that. It’s not particularly good at judging fibrosis or cirrhosis though, we’re told. You should have a much better idea of where you stand reviewing a combination of blood tests, U/S scan and Fibroscan. Remember that frank cirrhosis can generally be ascertained with blood tests alone; things like INR, platelets, albumin and other lab results are usually very telling of cirrhosis.
The U.S. hasn’t approved the Fibroscan for commercial use here. Biopsy remains the gold standard for gauging the extent of scarring/disease progression in the states.
Good luck and let us know how it goes—
Bill
I had multiple spider nevi on face, shoulders and chest; but my biopsy indicated stage 3-4 damage. I think there are other conditions outside of cirrhosis that can cause spider nevi too; they’re not exclusive to liver disease. When they appear with other signs such as stiff liver margins and known HCV they might be more suggestive of cirrhosis, though.
Regarding the question you asked Deb about the ‘ordinary scan’. An ultrasound scan is an excellent diagnostic tool for determining many things; it can locate masses, tumors, size organs and veins; things like that. It’s not particularly good at judging fibrosis or cirrhosis though, we’re told. You should have a much better idea of where you stand reviewing a combination of blood tests, U/S scan and Fibroscan. Remember that frank cirrhosis can generally be ascertained with blood tests alone; things like INR, platelets, albumin and other lab results are usually very telling of cirrhosis.
The U.S. hasn’t approved the Fibroscan for commercial use here. Biopsy remains the gold standard for gauging the extent of scarring/disease progression in the states.
Good luck and let us know how it goes—
Bill
Hi Bill
Thank you so much for all that info. My alt is normal, however i am showing signs outwardly such as the spider nieva. What would you make of that?
Also i know of someone with stage 4 cirrhosis which i believe is quite severe?
Lynne
Thank you so much for all that info. My alt is normal, however i am showing signs outwardly such as the spider nieva. What would you make of that?
Also i know of someone with stage 4 cirrhosis which i believe is quite severe?
Lynne
Oh i know what you mean about names .... just too hard!
I don't mind repeating anything, your help is great, can't seem to get answers out of doctors.
I tried tx for 4 wks 18 months ago. The sx for me were so severe (anemia & depression)
that i was taken off tx. Since then i have been taking anit viral herbal tablets and since my alt is normal and the 2 ordinary scans show my liver to look ok I have happily been waiting for the new tx in 2011/2012. After transferring to a different hospital the story seems quite different, ie, spider nieva, enlarged liver, and 2cm hard rim around liver.
Now i am thinking i need to go on tx again asap!
I am told a fibro scan will reveal alot more, do you know if an ordinary scan can tell very much at all?
I don't mind repeating anything, your help is great, can't seem to get answers out of doctors.
I tried tx for 4 wks 18 months ago. The sx for me were so severe (anemia & depression)
that i was taken off tx. Since then i have been taking anit viral herbal tablets and since my alt is normal and the 2 ordinary scans show my liver to look ok I have happily been waiting for the new tx in 2011/2012. After transferring to a different hospital the story seems quite different, ie, spider nieva, enlarged liver, and 2cm hard rim around liver.
Now i am thinking i need to go on tx again asap!
I am told a fibro scan will reveal alot more, do you know if an ordinary scan can tell very much at all?
I'm sorry Lynne I have no idea why doctors handle these things the way they do...like we are second class citizens. Whatever they did or didn't do I surely hope they are WRONG in this case (my doc told me I had no fibrosis but it turned out I was stage 3 - but that was my primary care doctor not a heptologist (she knew nothing I got rid of her).
Lets hope in this case it's exactly backwards to what mine was. Have you talked to the doctor about treatment? If you are still in early cirrhosis the best thing to do would be to get rid of the reason that your liver is being damaged of course.
I'm sorry if you've said all this before I try hard but can never remember all the different stories of the folks that come on the forum....I'm not a brainiac at all and just rememmbering names is hard enough for me! :)
Lets hope in this case it's exactly backwards to what mine was. Have you talked to the doctor about treatment? If you are still in early cirrhosis the best thing to do would be to get rid of the reason that your liver is being damaged of course.
I'm sorry if you've said all this before I try hard but can never remember all the different stories of the folks that come on the forum....I'm not a brainiac at all and just rememmbering names is hard enough for me! :)
Hi Lynne,
Fibrosis can be scored from F0 (no scarring) through F4 (which is then considered cirrhosis).
Then, cirrhosis is broken down different ways. The most important distinction is whether or not one has ‘compensated’ or ‘decompensated’ cirrhosis. With compensated cirrhosis, while the physical architecture of the liver may have changed, the organ continues to perform its intended tasks; it filters, synthesizes, manufactures, etc. As the liver decompensates, it begins to lose these functions; this is when varices, ascites, edema begin to show outwardly.
Another way to stage cirrhosis is by using the CTP (Child-Turcott-Pough) score, A through C; a Child-class A patient will have compensated disease; not so for Child-class B and C.
Another way to view this is via ‘MELD’ score, an acronym for Model End stage Liver Disease. This is widely used to assess morbidity, morality and to help determine the urgency for organ transplant. A MELD score calculator is available here:
http://www.mayoclinic.org/meld/mayomodel6.html
A quick link to MELD score and transplant criteria used by the San Francisco transplant center I treated with; I’m not sure how much of this data is useful or applicable to you in the UK, though:
http://www.cpmc.org/advanced/liver/patients/topics/MELD.html
Hopefully, none of this will be an issue for you, but if it is, some of this might be interesting to you. I believe most of this is applicable to the UK; you can obviously discuss all this in more depth with your hepatologist. All the best with your Fibroscan results; let us know what you find out—
Bill
Fibrosis can be scored from F0 (no scarring) through F4 (which is then considered cirrhosis).
Then, cirrhosis is broken down different ways. The most important distinction is whether or not one has ‘compensated’ or ‘decompensated’ cirrhosis. With compensated cirrhosis, while the physical architecture of the liver may have changed, the organ continues to perform its intended tasks; it filters, synthesizes, manufactures, etc. As the liver decompensates, it begins to lose these functions; this is when varices, ascites, edema begin to show outwardly.
Another way to stage cirrhosis is by using the CTP (Child-Turcott-Pough) score, A through C; a Child-class A patient will have compensated disease; not so for Child-class B and C.
Another way to view this is via ‘MELD’ score, an acronym for Model End stage Liver Disease. This is widely used to assess morbidity, morality and to help determine the urgency for organ transplant. A MELD score calculator is available here:
http://www.mayoclinic.org/meld/mayomodel6.html
A quick link to MELD score and transplant criteria used by the San Francisco transplant center I treated with; I’m not sure how much of this data is useful or applicable to you in the UK, though:
http://www.cpmc.org/advanced/liver/patients/topics/MELD.html
Hopefully, none of this will be an issue for you, but if it is, some of this might be interesting to you. I believe most of this is applicable to the UK; you can obviously discuss all this in more depth with your hepatologist. All the best with your Fibroscan results; let us know what you find out—
Bill
I had an app. recently at a new hos. with new doc. He felt my liver and told me it was enlarged and also i had spider nieva spots on my neck. He suggested a fibroscan which is due. In the meantime i received a copy of a letter sent to my doc from the hos saying that he expected that i have advanced liver fibrosis and possibly cirrhosis. The letter also said he felt a 2 cm hard edge around my liver. I assume it was thought that these details had been discussed with me at the hos., infact they hadn't so it was a bit of a shock.
As for a biopsy, no one has ever mentioned that to me during my journey down the hep c world ...
Would love to hear back from you
Lynne
As for a biopsy, no one has ever mentioned that to me during my journey down the hep c world ...
Would love to hear back from you
Lynne
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