Biopsy cirrhosis and waiting for a fibroscan - whats the difference?

[charleeeeeeeeeeeee]

Hi All, I had a biopsy a year ago which (although I only just found out) says I have cirrhosis.

I have had scans and ultrasounds and loads of bloods for my LFTs and other stuff, kidneys, FBC... and everything is absolutely normal. No symptoms now apart from I feel the cold! I'm very fit and (apart from my liver) healthy. This is from drinking I am sure, which I no longer do , and its not autoimmune. I am slim and eat everything super healthy going! Any have milk thistle and B Vits and multi vits and folic acid every day.

I missed a follow up fibroscan because I moved from the south to the north and am now on a long waiting list for one and to see a hepatologist as it is not classed as urgent...but I am quite worried sick as I have had only a medical secretary tell me over the phone about my cirrhosis.

I am wondering what my fibroscan will say? My biopsy was to test for autoimmune hepatitis. Did they test all my liver in the biopsy? Is it cirrhosis all over?

Thanks for your help!

[AyrshireK]

Your biopsy looked at your liver on a cellular level - it is the gold standard test to see what is causing any liver problem as it can identify what changes are going on within and around cells, bile ducts and pick up fibrous changes etc. It does only look at small portions of the liver but once you have cirrhosis this isn't normally a bit here, bit there situation but throughout the liver tissue. Cirrhosis will also generally show up on an ultrasound scan in that the shape and echo texture of the liver are changed.

Similar to an ultrasound or dopplar the fibroscan 'wand' is passed over your liver area and readings are taken across the liver with an average or median score being the result (CAP score reflects fatty change and kPa reflects how much fibrous tissue is in the liver resulting in a F0-F4 Metavir Score which grades the degree of fibrous change).

Fibrosis score:

F0 = no fibrosis

F1 = portal fibrosis without septa

F2 = portal fibrosis with few septa

F3 = numerous septa without cirrhosis

F4 = cirrhosis

My hubbies biopsies proved inconclusive for his auto-immune cirrhosis (cause) but did confirm the cirrhosis diagnosis which was already clear in ultrasound scans and by the fact he presented at hospital with life threatening end stage symptoms. He has never had a fibroscan.

Do hope you get some answers soon as to your situation. But good news is if you do have cirrhosis you are symptom free at present and doing ok. Be wary of taking any supplements - they don't undergo the rigourous testing of medicines and can affect liver function blood test results which when you are still undergoing diagnosis tests can give false readings. We've had members on here who've been told NOT to take milk thistle in particular as it can in some cases be hazardous to the liver - all alternative remedies or supplements should always be run past your medical team first.

Katie

[Worriedmamabear in reply to AyrshireK]

katie

i am catching up with inconclusive posts, it appears the liver biopsy my son had 10 days ago has come back inconclusive?

what does this mean i see your hubby was inconclusive is that to what has caused the actual cirrhosis? he is in hospital today getting more fluid drained and they said the pathologists will have a meeting on tuesday to review his case?

not sure where that leaves us - no official consultant meeting just what my son has heard on on the ward?

[AyrshireK in reply to Worriedmamabear]

My hubbies first biopsy proved inconclusive as to cause - they explained they had gotten too small a sample in hubbies case. They decided his condition was auto-immune cirrhosis due to antibodies that were present in blood tests. A second biopsy done via the transjugular route two years later showed no active inflammation but confirmed his cirrhosis and damaged liver cells .......... they say he had auto-immune hepatitis in the past but it had done its damage and burned out.

There are some people who never get a confirmed reason for their cirrhosis and they often just get labelled as 'cryptogenic cirrhosis'. Unfortunately this means they can't identify the cause.

[TimothyB]

Biopsy is the test consultant will trust the most.

I used to take milk thistle every day. Decided not to do so as I prefer healthy eating (avoid alcohol, too much meat, deep fried stuff).