Guest guest Posted June 4, 2003 Report Share Posted June 4, 2003 I posted here last week reference my run to the ER, during the course of which they did some lab work...the results showing LFT within normal ranges. My gastro got those results and asked his nurse, " Has she EVER been normal?? " Now you can take it one of 2 ways, but I am sure he was just referring to the labs...I hope he was...LOL. My LFTS have been coming down, ever so very slowly over the past year, since my last flare, from the 300- 400 range, down to normal range now. Anyway, I saw my hep on Friday and relayed what had transpired. He was amazed as well...thought it was rather quick for the cyclosporine to have made that much of a difference, but hoping it was doing something. On my way out he handed me his clinic notes along with bx report. After reading those, and what happened last week, I feel really confused. I am not totally clear on everything in the notes, but here goes: The pressures obtained at the time [of bx] show that she has a hepatatic venous pressure of 12 mmHg. (What is the significance of that?) Her bx shows cirrhosis which is well established [bx report: trichrome stain confirms the presence of cirrhosis stage 4 of 4]. However her disease is quite active and she has grade 3 inflammation. [bx report: Moderate inflammatory infiltrate is seen at the interface throughout much of the biopsy. Lymphocytes predominate with small numbrs of plasma cells. Frequent acidophilic necrosis is seen.] Ok..so here is the question...if the inflammation is at a higher level than it was 2 years ago and the scarring is at the level it is, how do I end up with normal LFT? Are there any sites or sources that might address such contradictory findings? Thanks for listening!! Changing my address to the state of confusion, Love yas, nne Quote Link to comment Share on other sites More sharing options...
Guest guest Posted June 4, 2003 Report Share Posted June 4, 2003 Yes, this can happen, Jerry explained it a few months ago and I'm sure will again. I can't help, but can understand your frustration. I know the pressure in the hepatic vein is important but I have no idea what is normal or abnormal. Patty [ ] Got a question.... I posted here last week reference my run to the ER, during the course of which they did some lab work...the results showing LFT within normal ranges. My gastro got those results and asked his nurse, " Has she EVER been normal?? " Now you can take it one of 2 ways, but I am sure he was just referring to the labs...I hope he was...LOL. My LFTS have been coming down, ever so very slowly over the past year, since my last flare, from the 300- 400 range, down to normal range now. Anyway, I saw my hep on Friday and relayed what had transpired. He was amazed as well...thought it was rather quick for the cyclosporine to have made that much of a difference, but hoping it was doing something. On my way out he handed me his clinic notes along with bx report. After reading those, and what happened last week, I feel really confused. I am not totally clear on everything in the notes, but here goes: The pressures obtained at the time [of bx] show that she has a hepatatic venous pressure of 12 mmHg. (What is the significance of that?) Her bx shows cirrhosis which is well established [bx report: trichrome stain confirms the presence of cirrhosis stage 4 of 4]. However her disease is quite active and she has grade 3 inflammation. [bx report: Moderate inflammatory infiltrate is seen at the interface throughout much of the biopsy. Lymphocytes predominate with small numbrs of plasma cells. Frequent acidophilic necrosis is seen.] Ok..so here is the question...if the inflammation is at a higher level than it was 2 years ago and the scarring is at the level it is, how do I end up with normal LFT? Are there any sites or sources that might address such contradictory findings? Thanks for listening!! Changing my address to the state of confusion, Love yas, nne Quote Link to comment Share on other sites More sharing options...
Guest guest Posted June 4, 2003 Report Share Posted June 4, 2003 ne.... I post at least once a week reminding people that what we call LFTs ( liver " function " tests) don't actually measure how our liver is functioning at all...a more reliable test is the albumin serum levels and prothrombin time...they can show if the liver is doing what it is supposed to be doing. In advanced stages of liver damage the liver is so damaged that some of the things they normally do are not being done. Our ASTs and ALTS are enzymes that are released when a liver cell is attacked (by whatever) as part of repair attempts. If the liver has become so greatly disarrayed as yours seem to be the hepatocytes just no longer make those enzymes hence they show up normal on your blood tests ....more reliable indications are such things as varices, ascites, encephalopathy....all of which are caused by portal (vein ) hypertension...the portal vein can't function as usual..... it becomes blocked or squeezed due to the changin architecture of the liver (from dying cells, laying down of collagen with its resulting fibrosis (scarring) and the attempts to regenerate new cells which form little nodules that have no functionak connection with each other) When the portal vein is blocked say fluids leak out into the body, the blood trys to find other paths to the heart etc. The liver can't process proteins and produce albumin...a protein that equalizes the tension between the walls of vessels and its suroundings. So anyway it is entirely possible to have normal " LFTs " and ongoing liver damage, just as its possible to have high LFTs and little or no damage at the time of your blood draw. love jerry Quote Link to comment Share on other sites More sharing options...
Guest guest Posted June 5, 2003 Report Share Posted June 5, 2003 nne, I'm sure Jerry will remember. There was a site someone posted last week that spoke of cirrhosis and how and why the cirrhosis gets worse even with normal LFT's. Maybe Jerry will send it, as I am sure he remembers the site I'm speaking about. I think it was in an article specifically about AIH, if I remember correctly. Jerry, help us out please. Quote Link to comment Share on other sites More sharing options...
Guest guest Posted June 5, 2003 Report Share Posted June 5, 2003 ....I sent about 5-6 sites concerning your question . I can't find the one you're asking about...I sent it a while back and copied it and edited it to that specific subject and sent it a little while ago..... I looked thru the archives but can't find it. Anyway I have been rpeating over and over since I've been a member here that " LFTs do not measure te damage of one's liver. A person with cirrhosis would more likely have normal ASTs and ALTs because the cells are either dead or dying and so diffuse and scattered that they don't release enough of the enzymes to show elevation ....It can also be true that some one can have very high numbers yet haven't as yet caused significant damage. On-going or chronic slightly elevated numbers can cause a lot of damage....as someone said " smoldering " ...yet not seem significant on testing...it is important to warch for other signs and/or symtoms. That's funny because the stage of cancer I have (multiple myeloma) is called " smoldering myeloma " ...it just slowly " burns'...no flame up. love jerry Quote Link to comment Share on other sites More sharing options...
Recommended Posts
Join the conversation
You are posting as a guest. If you have an account, sign in now to post with your account.
Note: Your post will require moderator approval before it will be visible.