Biopsy results

Finally got my liver biopsy results, havent seen the doc yet, but here goes: non-alcoholic steatohepatitis, grade 6/8 activity with no evidence of autoimmune pathology. There is also advanced fibrosis with bridging septa (stage 3/4) but not conclusive features of cirrhosis. Given my high fibroscan reading (30.7 KPa) he is saying he is going to continue to manage my condition as having advanced fibrosis / compensated cirrhosis.

Good no autoimmune pathology I think, but am struggling to find much info on the grading / staging, any info would be much appreciated. I really dont know how I feel, whether it is good or bad, whether I should be happy or sad. I dont think it is overly different to what the doc said before the biopsy

Anne

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  • 😘😘😘 well - I would say 'yippee' I know what it is - 'boooo' it's 'cirrhosis' then 'yahoooo' it's compensated' - 😘😘😘 don't blame you for the reaction ❤️❤️ I suppose it's good you know what it is so that now a definitive plan can be made - also remember that people can stay for many years at this stage if certain tweeks are made in lifestyle choice - so that's a good thing xx I am also unaware of the grading as we never had that info a few years ago - Robs was 'end stage cirrhosis' then very quickly after 'liver failure/decompensated' so never had a grade ??? Perhaps use the Child-Pugh thing - that's all I remember them saying to go by - you can find it online how to work it out by putting in blood results so you will need up to date bloods - or you can do exactly what I would have done if I could do it all again and not look up anything !!!! Once you start looking then that's it 😂😂😂😂 you will find things you never knew you had xxxxx we are all here to help and listen to whatever questions/fear/comments you have ❤️❤️❤️❤️ hugs xx

  • Ive got to be honest, I need to know what all the numbers mean and wont be able to not look things up. Often doctors dont give you all the information and I need it all. Maybe I need to trust a bit more but I need to know what they are basing their decisions on. I got told my Child Pugh score was A5 which is as good as it gets really.

    I have been really irritated this week and it has shown, so really need to find a better way of dealing with the emotions, particularly in response to doctors who seem to open their mouths without thinking :-)

  • I would say its a good thing that no immune issues are present. But I have read your previous posts and suspect the cause was alcohol, although you stopped It appears your Liver was already poorly. Your comment "Within a couple of years my liver tests were back to normal" indicates you had some serious Alcoholic Hepatitis when you stopped and it lingered for years. I have seen Liver numbers be normal in 3 or 4 months after an acute case of Alcoholic hepatitis, I have never seen someone have bad numbers for several years after stopping alcohol.

    Im pretty shocked that no further testing was done years ago to determine damage, although the treatment would be the same in anycase and there was no Fibroscan back then.

  • I dont know why they didnt do further checks, probably wont know now. My blood tests went back to normal ranges and stayed there for over 10 years and then started to rise, I have regular tests due to my diabetes. but to be honest my gp was still happy to do nothing until my blood glucose control went awol, I ended up having a couple of severe hypos, got referred back to the diabetes consultant who straight away referred me the the liver man.

  • I know you don't have hep b but this article explains biopsy grading and staging relatively simply.

    hcvadvocate.org/hepatitis/f...

    Biopsies measure both the level of damage, ie how advanced the fibrosis or cirrhosis is, and the level of inflammation, the higher this level the faster the damage is progressing. Two people could have the same level of cirrhosis, but if one has more inflammation than the other their liver will get worse faster.

    To complicate things there are different scoring systems which don't use the same numbers: Ishak, Metavir, Knodell and HAI. Your biopsy report might say which system has been used.

  • Thank you, that makes things a little clearer, so can ask a few more specific questions when I see the doc.

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